Impact of obstructive sleep apnea in recruitment of coronary collaterality during inaugural acute myocardial infarction

Abstract

BackgroundObstructive sleep apnea (OSA) may lead to myocardial preconditioning by increasing coronary collateral vessel recruitment in patients with acute coronary occlusion. AimTo determine the relationship between the severity of obstructive sleep apnea and coronary collaterality during acute myocardial infarction. MethodsThis study prospectively included 71 patients with an inaugural myocardial infarction who had undergone a coronary angiography within 24h of onset. All patients underwent an overnight polygraph before discharge and were classified according to the apnea–hypopnea index (AHI). Coronary collaterals were scored by visual analyses and according to the Rentrop grading system. ResultsMean age was 59±11years and 83% of patients were men. All patients had complete or subtotal occlusion of the infarct-related artery. After the sleep study, patients were divided into two groups: 25 were suffering from OSA (AHI>15/h). Patients with OSA showed better collateral vessel development (Rentrop score≥1) compared to non-OSA patients (68 vs. 41%, P=0.032). AHI was significantly higher in patients with developed coronary collaterals (Rentrop≥1) compared to those without collaterality (17.74±13.2 vs. 12.24±10.9, P=0.025). ConclusionCoronary collateral development may be increased in OSA patients who are presenting with a first myocardial infarction.