Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction

OBJECTIVE Obstructive sleep apnea(OSA)is a potential cardiovascular risk.We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial infarction(AMI).METHODS We prospectively enrolled 252 AMI elderly patients(mean age,68.5±6.9 years)who were undergoing revascularization and completed a sleep study during their hospitalization.All subjects were categorized into non-OSA(apnea–hypopnea index(AHI)<15,n=130)and OSA(AHI≥15,n=122)groups based on the AHI.The changes in the autonomic nervous system,incidence of arrhythmia during nocturnal sleep,and major adverse cardiovascular and cerebrovascular events(MACCEs)were compared between the groups.RESULTS The mean AHI value in all AMI patients was 22.8±10.9.OSA patients showed higher levels of body mass index and peak high-sensitivity C-reactive protein and lower levels of minimum nocturnal oxygen saturation(Min Sa O2),as well as greater proportion of multivessel coronary artery disease(all P<0.05).The OSA group also showed significant increases in heart rate variability and heart rate turbulence onset(both P<0.05)and higher incidence of arrhythmia(including sinus,atrial,and ventricular in origin).At a median follow-up of 6 months(mean 0.8–1.6 years),OSA(AHI≥15)combined with hypoxia(Min Sa O2≤80%)was independently associated with the incidence of MACCEs(hazard ratio[HR]:4.536;95%confidence interval[CI]:1.461-14.084,P=0.009)after adjusting for traditional risk factors.CONCLUSIONS OSA and OSA-induced hypoxia may correlate with the severity of myocardial infarction,increase the occurrence of heart rhythm disorders in elderly subacute MI patients,and worsen their short-term poor outcomes.

CLINICAL ANALYSIS OF OBSTRUCTIVE SLEEP APNEA SYNDROME WITH ACUTE RESPIRATORY FAILURE

feSUnt6 ObjeCtif POur studier ies coractdristiques cliniques du syndrew on (Ohetructive sleep aprm ) accomwide i' inSUffimnce respiratoire algUe adns ie but d' une reconnaiamnce et d' un traitement Pr4cOCes en cos d' urgence. metL' analyse des caractdristiques cliniques et deS ~mens de labotoire a ate rdalifor chez 9 cos de syndronze on. Anulfots8 oas boiculins et 1 oas fdminin PrdSentent tons une oddity avec BMI moron 44, 97 kg/mZ (45, 25kg/m' dens ie oas fdminin ).L 'age ntopen est de 67,89 ans (61 -- 74 ...