TY - JOUR
T1 - Sleep apnea prevalence in acute myocardial infarction - The Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study
AU - Ludka, Ondrej
AU - Stepanova, Radka
AU - Vyskocilova, Martina
AU - Galkova, Lujza
AU - Mikolaskova, Monika
AU - Belehrad, Milos
AU - Kostalova, Jana
AU - Mihalova, Zuzana
AU - Drozdova, Adela
AU - Hlasensky, Jiri
AU - Gacik, Michal
AU - Pudilova, Lucie
AU - Mikusova, Tereza
AU - Fischerova, Blanka
AU - Sert-Kuniyoshi, Fatima
AU - Somers, Virend K.
AU - Spinar, Jindrich
AU - Kara, Tomas
N1 - Funding Information:
Dr. Ludka, Dr. Kara, Msc. Stepanova, Bsc. Vyskocilova, Dr. Galkova, Dr. Drozdova, Dr. Mikusova, Dr. Fischerova and Dr. Spinar are supported by European Regional Development Fund — Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123 ). Dr. Ludka, Dr. Kara and MSc. Stepanova are supported by European Social Fund within the project ICRC Human Bridge — Support of Study Stays of Czech Researchers Abroad: Young Talent Incubator (No. CZ.1.07/2.3.00/20.0022 ). Dr. Kara is supported by the IGA of Czech Ministry of Health No. NT11401-5/2011 and by European Regional Development Fund ICRC-ERA-HumanBridge (No. 316345 ). tDr. Somers is supported by NIH R01 HL65176 , IGA of Czech Ministry of Health No. NT11401-5/2011 , European Regional Development Fund , Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123 ), and by a gift from the Philips Foundation to the Mayo Foundation.
PY - 2014/9
Y1 - 2014/9
N2 - Background While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients. Methods We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 h post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (< 5 events/h), mild SA (5-15 events/h), moderate SA (15-30 events/h), and severe SA (≥ 30 events/h). Results Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥5 events/h, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6 AM to 12 PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12 AM to 6 AM (all p < 0.05). Conclusion There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6 AM and noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.
AB - Background While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients. Methods We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 h post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (< 5 events/h), mild SA (5-15 events/h), moderate SA (15-30 events/h), and severe SA (≥ 30 events/h). Results Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥5 events/h, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6 AM to 12 PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12 AM to 6 AM (all p < 0.05). Conclusion There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6 AM and noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.
KW - Acute myocardial infarction
KW - Day-night variation
KW - Prevalence
KW - Sleep apnea
UR - http://www.scopus.com/inward/record.url?scp=84906319129&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84906319129&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2014.06.020
DO - 10.1016/j.ijcard.2014.06.020
M3 - Article
C2 - 25064202
AN - SCOPUS:84906319129
VL - 176
SP - 13
EP - 19
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -