Abstract 11148: Effects of Obstructive Sleep Apnea on In-Hospital Mortality in Patients With Myocardial Infarction

Abstract

Introduction: Obstructive sleep apnea (OSA) is a common chronic disorder characterized by repetitive episodes of apnea, resulting in intermittent asphyxia and arousal from sleep. OSA is associated with adverse medical outcomes, including amplified sympathetic activity and fluctuations in blood pressure and heart rate. Studies have shown higher prevalence and incidence of hypertension among patients with OSA. Patients with OSA had a higher incidence of cardiovascular events included stroke and myocardial infarction (MI). OSA is also linked to higher cardiovascular disease morbidity. Hypothesis: This study investigated the impact of OSA on in-hospital mortality in patients with MI. Methods: We used the Nationwide Inpatient Sample, a publicly available database of inpatient care. We analyzed the mortality among MI victims with OSA compared to patients without OSA. Ultimately the care of over 840,000 patients with MI was analyzed for the primary endpoints. Analyses were adjusted for demographics, comorbid conditions, and hospital characteristics. Results: OSA patients constituted 3.47% of all patients with MI. OSA was more prevalent among patients with NSTEMI, compare to STEMI counterparts (3.84% vs 2.60% respectively). Logistic regression was used to estimate the overall probability of in-hospital death with adjustments for age, sex, race, Elixhauser comorbidities, primary payer, and hospital characteristics including location, teaching status, bed-size, and total admissions. The adjusted odd ratio of in-hospital death was 1.36 (95%CI: 1.17-1.59) and 1.03 (95%CI: 0.97-1.10) for STEMI and NSTEMI respectively. OSA was associated with longer hospital stay for both STEMI and NSTEMI. (Length of stay>3 days OR: 1.85 (95%CI: 1.70-2.01) and 1.44 (95%CI: 1.38-1.49) respectively) Conclusions: OSA is associated with higher mortality, and lengthier hospitalization among patients with MI. Targeted interventions may improve outcomes in this group.