The Association Between Obstructive Sleep Apnea And Acute Coronary Syndrome

Objective: This study in hospitalized patients for clinical diagnosis of acute coronary syndrome of the Watch-PAT completed sleep phase detection,to understand the clinical features of patients with acute coronary syndrome,and to explore its possible contact and OSA influence on the prognosis of patients with acute coronary syndrome,providing a new method for the treatment of acute coronary syndrome patients.METHODS: A total of 195 patients with acute coronary syndrome who were admitted to the Department of Cardiology,Provincial Hospital of Anhui Medical University from May 2019 to December 2019 were included.All patients underwent watch-PAT bedside sleep breathing monitoring during their stay in hospital.According to the Apnea hypopnea index during rapid eye movement period(AHIREM),the patients were divided into two groups: control group(AHIREM ≤ 15times/hour)and abnormal group(AHIREM > 15 times/hour).Baseline data of patients in both groups were collected,including general demographic characteristics(age,gender,BMI),clinical data(specific types of acute coronary syndrome,previous related medical history,etc.),and laboratory related indicators(WBC).Red blood cell count(RBC);Platelet count(PLT);Thrombocytopenia(PCT);Mean platelet volume(MPV);Hemoglobin(HGB);Creatinine(CRE);Total cholesterol(TC);Triglyceride(TG);Low density lipoprotein cholesterol(LDL-C);High density lipoprotein cholesterol(HDL-C),and sleep monitoring data;The patients were followed up for 20 months,and the occurrence of major adverse cardiovascular and cerebrovascular events(MACCE)such as cardiogenic death,nonfatal myocardial infarction,readmission due to angina pectoris or heart failure,and non-fatal ischemic stroke were recorded.Results: There were 195 patients with acute coronary syndrome,including 140 patients in the abnormal group(AHIREM > 15 times/h)and 55 patients in the control group(AHIREM≤ 15 times/h).There were no significant differences between the two groups in age,gender,previous related medical history and types of acute coronary syndrome.Group of patients with abnormal body mass index(25.06 + /-3.26 vs.23.69 + /-2.85,P = 0.007,P ? 0.05),serum triglycerides(1.72 + /-1.02 vs.1.39 + /-0.74,P = 0.027,P ? 0.05),left atrial diameter(41.8 + /-4.72 vs.40.2 + /-4.64,P =0.032,P ? 0.05),left ventricular end-diastolic diameter(53.8 + /-6.4 vs.55.9 + /-6.2,P = 0.036,P? 0.05)were higher than the control group,the abnormal group of left ventricular ejection fraction is lower than the control group(58.3 + /-11.3 vs.61.8 + /-10.0,P = 0.047,P ? 0.05).The correlation analysis of Kendall’s Tau_B showed that AHIREM and LA(r: 0.138;P = 0.035,P<0.05),LVEDD(r: 0.128;P = 0.010,P<0.05)was positively correlated with LVEF(r:-0.125;P = 0.011,P<0.05)was negatively correlated.Binary Logistic regression analysis showed that BMI(OR,1.162;95% CI: 1.042 1.296;P=0.005),left ventricular ejection fraction(OR,0.967;95% CI:0.936 0.999;P=0.043)was a risk factor for AHIREM > 15 BPS/hour.Survival analysis found that20 months of follow-up,the two groups of patients with cumulative no MACE event survival difference was statistically significant(77.1% VS 90.9%,the Log rank: 4.723,P = 0.03,P ?0.05).Age,sex,type of acute coronary syndrome,AHIREM and AHI were included in Cox proportional risk regression model for multivariate regression analysis.15)is a risk factor affecting the prognosis of patients with acute coronary syndrome.Conclusion: Abnormal levels of AHIREM(AHIREM >15 times /h)patients with acute coronary syndrome(ACS)were more likely to have higher BMI and triglyceride levels.Abnormal levels of AHIREM(AHIREM >15 times/hour)may aggravate left ventricular remodeling in patients with acute coronary complications and affect clinical outcomes.AHIREM >15 times /h was an independent risk factor for adverse cardiovascular events in patients with acute coronary syndrome.