Day-Night Variation of Acute Myocardial Infarction in Obstructive Sleep Apnea

Fatima H. Sert Kuniyoshi, Arturo Garcia-Touchard, Apoor S. Gami, Abel Romero-Corral, Christelle van der Walt, Snigdha Pusalavidyasagar, Tomas Kara, Sean M. Caples, Gregg S. Pressman, Elisardo C. Vasquez, Francisco Lopez-Jimenez, Virend Somers

Research output: Contribution to journalArticle

183 Citations (Scopus)

Abstract

Objectives: This study sought to evaluate the day-night variation of acute myocardial infarction (MI) in patients with obstructive sleep apnea (OSA). Background: Obstructive sleep apnea has a high prevalence and is characterized by acute nocturnal hemodynamic and neurohormonal abnormalities that may increase the risk of MI during the night. Methods: We prospectively studied 92 patients with MI for which the time of onset of chest pain was clearly identified. The presence of OSA was determined by overnight polysomnography. Results: For patients with and without OSA, we compared the frequency of MI during different intervals of the day based on the onset time of chest pain. The groups had similar prevalence of comorbidities. Myocardial infarction occurred between 12 am and 6 am in 32% of OSA patients and 7% of non-OSA patients (p = 0.01). The odds of having OSA in those patients whose MI occurred between 12 am and 6 am was 6-fold higher than in the remaining 18 h of the day (95% confidence interval: 1.3 to 27.3, p = 0.01). Of all patients having an MI between 12 am and 6 am, 91% had OSA. Conclusions: The diurnal variation in the onset of MI in OSA patients is strikingly different from the diurnal variation in non-OSA patients. Patients with nocturnal onset of MI have a high likelihood of having OSA. These findings suggest that OSA may be a trigger for MI. Patients having nocturnal onset of MI should be evaluated for OSA, and future research should address the effects of OSA therapy for prevention of nocturnal cardiac events.

Original languageEnglish (US)
Pages (from-to)343-346
Number of pages4
JournalJournal of the American College of Cardiology
Volume52
Issue number5
DOIs
StatePublished - Jul 29 2008

Fingerprint

Obstructive Sleep Apnea
Myocardial Infarction
Sleep Apnea Syndromes
Chest Pain
Polysomnography
Comorbidity
Hemodynamics
Confidence Intervals

Keywords

  • day-night variation
  • myocardial infarction
  • obstructive sleep apnea

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Sert Kuniyoshi, F. H., Garcia-Touchard, A., Gami, A. S., Romero-Corral, A., van der Walt, C., Pusalavidyasagar, S., ... Somers, V. (2008). Day-Night Variation of Acute Myocardial Infarction in Obstructive Sleep Apnea. Journal of the American College of Cardiology, 52(5), 343-346. https://doi.org/10.1016/j.jacc.2008.04.027

Day-Night Variation of Acute Myocardial Infarction in Obstructive Sleep Apnea. / Sert Kuniyoshi, Fatima H.; Garcia-Touchard, Arturo; Gami, Apoor S.; Romero-Corral, Abel; van der Walt, Christelle; Pusalavidyasagar, Snigdha; Kara, Tomas; Caples, Sean M.; Pressman, Gregg S.; Vasquez, Elisardo C.; Lopez-Jimenez, Francisco; Somers, Virend.

In: Journal of the American College of Cardiology, Vol. 52, No. 5, 29.07.2008, p. 343-346.

Research output: Contribution to journalArticle

Sert Kuniyoshi, FH, Garcia-Touchard, A, Gami, AS, Romero-Corral, A, van der Walt, C, Pusalavidyasagar, S, Kara, T, Caples, SM, Pressman, GS, Vasquez, EC, Lopez-Jimenez, F & Somers, V 2008, 'Day-Night Variation of Acute Myocardial Infarction in Obstructive Sleep Apnea', Journal of the American College of Cardiology, vol. 52, no. 5, pp. 343-346. https://doi.org/10.1016/j.jacc.2008.04.027
Sert Kuniyoshi FH, Garcia-Touchard A, Gami AS, Romero-Corral A, van der Walt C, Pusalavidyasagar S et al. Day-Night Variation of Acute Myocardial Infarction in Obstructive Sleep Apnea. Journal of the American College of Cardiology. 2008 Jul 29;52(5):343-346. https://doi.org/10.1016/j.jacc.2008.04.027
Sert Kuniyoshi, Fatima H. ; Garcia-Touchard, Arturo ; Gami, Apoor S. ; Romero-Corral, Abel ; van der Walt, Christelle ; Pusalavidyasagar, Snigdha ; Kara, Tomas ; Caples, Sean M. ; Pressman, Gregg S. ; Vasquez, Elisardo C. ; Lopez-Jimenez, Francisco ; Somers, Virend. / Day-Night Variation of Acute Myocardial Infarction in Obstructive Sleep Apnea. In: Journal of the American College of Cardiology. 2008 ; Vol. 52, No. 5. pp. 343-346.
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abstract = "Objectives: This study sought to evaluate the day-night variation of acute myocardial infarction (MI) in patients with obstructive sleep apnea (OSA). Background: Obstructive sleep apnea has a high prevalence and is characterized by acute nocturnal hemodynamic and neurohormonal abnormalities that may increase the risk of MI during the night. Methods: We prospectively studied 92 patients with MI for which the time of onset of chest pain was clearly identified. The presence of OSA was determined by overnight polysomnography. Results: For patients with and without OSA, we compared the frequency of MI during different intervals of the day based on the onset time of chest pain. The groups had similar prevalence of comorbidities. Myocardial infarction occurred between 12 am and 6 am in 32{\%} of OSA patients and 7{\%} of non-OSA patients (p = 0.01). The odds of having OSA in those patients whose MI occurred between 12 am and 6 am was 6-fold higher than in the remaining 18 h of the day (95{\%} confidence interval: 1.3 to 27.3, p = 0.01). Of all patients having an MI between 12 am and 6 am, 91{\%} had OSA. Conclusions: The diurnal variation in the onset of MI in OSA patients is strikingly different from the diurnal variation in non-OSA patients. Patients with nocturnal onset of MI have a high likelihood of having OSA. These findings suggest that OSA may be a trigger for MI. Patients having nocturnal onset of MI should be evaluated for OSA, and future research should address the effects of OSA therapy for prevention of nocturnal cardiac events.",
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AU - Garcia-Touchard, Arturo

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AU - Romero-Corral, Abel

AU - van der Walt, Christelle

AU - Pusalavidyasagar, Snigdha

AU - Kara, Tomas

AU - Caples, Sean M.

AU - Pressman, Gregg S.

AU - Vasquez, Elisardo C.

AU - Lopez-Jimenez, Francisco

AU - Somers, Virend

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N2 - Objectives: This study sought to evaluate the day-night variation of acute myocardial infarction (MI) in patients with obstructive sleep apnea (OSA). Background: Obstructive sleep apnea has a high prevalence and is characterized by acute nocturnal hemodynamic and neurohormonal abnormalities that may increase the risk of MI during the night. Methods: We prospectively studied 92 patients with MI for which the time of onset of chest pain was clearly identified. The presence of OSA was determined by overnight polysomnography. Results: For patients with and without OSA, we compared the frequency of MI during different intervals of the day based on the onset time of chest pain. The groups had similar prevalence of comorbidities. Myocardial infarction occurred between 12 am and 6 am in 32% of OSA patients and 7% of non-OSA patients (p = 0.01). The odds of having OSA in those patients whose MI occurred between 12 am and 6 am was 6-fold higher than in the remaining 18 h of the day (95% confidence interval: 1.3 to 27.3, p = 0.01). Of all patients having an MI between 12 am and 6 am, 91% had OSA. Conclusions: The diurnal variation in the onset of MI in OSA patients is strikingly different from the diurnal variation in non-OSA patients. Patients with nocturnal onset of MI have a high likelihood of having OSA. These findings suggest that OSA may be a trigger for MI. Patients having nocturnal onset of MI should be evaluated for OSA, and future research should address the effects of OSA therapy for prevention of nocturnal cardiac events.

AB - Objectives: This study sought to evaluate the day-night variation of acute myocardial infarction (MI) in patients with obstructive sleep apnea (OSA). Background: Obstructive sleep apnea has a high prevalence and is characterized by acute nocturnal hemodynamic and neurohormonal abnormalities that may increase the risk of MI during the night. Methods: We prospectively studied 92 patients with MI for which the time of onset of chest pain was clearly identified. The presence of OSA was determined by overnight polysomnography. Results: For patients with and without OSA, we compared the frequency of MI during different intervals of the day based on the onset time of chest pain. The groups had similar prevalence of comorbidities. Myocardial infarction occurred between 12 am and 6 am in 32% of OSA patients and 7% of non-OSA patients (p = 0.01). The odds of having OSA in those patients whose MI occurred between 12 am and 6 am was 6-fold higher than in the remaining 18 h of the day (95% confidence interval: 1.3 to 27.3, p = 0.01). Of all patients having an MI between 12 am and 6 am, 91% had OSA. Conclusions: The diurnal variation in the onset of MI in OSA patients is strikingly different from the diurnal variation in non-OSA patients. Patients with nocturnal onset of MI have a high likelihood of having OSA. These findings suggest that OSA may be a trigger for MI. Patients having nocturnal onset of MI should be evaluated for OSA, and future research should address the effects of OSA therapy for prevention of nocturnal cardiac events.

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