Prognostic implication of obstructive sleep apnea diagnosed by post-discharge sleep study in patients presenting with acute coronary syndrome

Abstract

ObjectiveWe aimed to determine the prognostic implications of obstructive sleep apnea (OSA) diagnosed during the recovery phase of acute coronary syndrome (ACS). MethodsPatients presenting with ACS and treated with percutaneous coronary intervention were recruited prospectively for a home-based sleep study within 30days of hospital discharge. Major adverse cardiac and cerebrovascular events (MACCEs) assessed included cardiac death, myocardial infarction, stroke, unplanned revascularization, and hospitalization for heart failure. ResultsOf the 85 patients recruited, 68 successfully completed the study. The median time from percutaneous coronary intervention to sleep study was 14days (interquartile range: 7.5–27days). OSA was diagnosed in 24 patients (35.3%) (apnea–hypopnea index ⩾15). A drug-eluting stent was implanted into the target lesion in 45 patients (66.2%). None of the study patients had received treatment for OSA. At 24-month follow-up, the MACCE incidence was 34.9% in the OSA group and 5.1% in the non-OSA group (P=0.008, log-rank test). After adjusting for the possible confounding effect of age, gender, coronary intervention indications, hypertension, smoking, and body mass index, OSA remained an independent predictor of MACCEs (adjusted hazard ratio, 6.95; 95% confidence interval, 1.17–41.4; P=0.033). ConclusionOSA diagnosed in patients treated with percutaneous coronary intervention for ACS by post-discharge sleep studies conducted 2weeks after percutaneous coronary intervention was independently associated with MACCEs at 24-month follow-up.