Respiratory Polygraphy Patterns and Risk of Recurrent Cardiovascular Events in Patients With Acute Coronary Syndrome

被引：0

作者：

Zapater, Andrea ^{[1
,2
]}

Solelhac, Geoffroy ^{[3
]}

Sanchez-de-la-Torre, Alicia ^{[2
,4
]}

Gracia-Lavedan, Esther ^{[2
,4
]}

Benitez, Ivan David ^{[2
,4
]}

Torres, Gerard ^{[2
,4
]}

De Batlle, Jordi ^{[2
,4
]}

Haba-Rubio, Jose ^{[3
]}

Berger, Mathieu ^{[3
]}

Abad, Jorge ^{[2
,5
]}

Duran-Cantolla, Joaquin ^{[2
,6
]}

Urrutia, Amaia ^{[7
]}

Mediano, Olga ^{[2
,8
]}

Masdeu, Maria Jose ^{[2
,9
]}

Ordax-Carbajo, Estrella ^{[10
]}

Masa, Juan Fernando ^{[2
,11
]}

De la Pena, Monica ^{[12
]}

Mayos, Merce ^{[2
,13
]}

Coloma, Ramon ^{[14
]}

Montserrat, Josep Maria ^{[2
,15
]}

Chiner, Eusebi ^{[16
]}

Minguez, Olga ^{[4
]}

Pascual, Lydia ^{[4
]}

Cortijo, Anunciacion ^{[4
]}

Martinez, Dolores ^{[4
]}

Dalmases, Mireia ^{[2
,4
]}

Lee, Chi-Hang ^{[17
]}

McEvoy, R. Doug ^{[18
]}

Barbe, Ferran ^{[2
,3
]}

Heinzer, Raphael ^{[3
,19
]}

Sanchez-de-la-Torre, Manuel ^{[1
,2
]}

Spanish Sleep Network

机构：

[1] Univ Lleida, Hosp Universitari Arnau Vilanova St Maria, Fac Nursing & Physiotherapy, Dept Nursing & Physiotherapy, Lleida, Spain

[2] Ctr Invest Biomed Red Enfermedades Respiratorias C, Madrid, Spain

[3] Univ Lausanne, Lausanne Univ Hosp, Ctr Invest & Res Sleep, Lausanne, Switzerland

[4] Hosp Universitari Arnau Vilanova St Maria, Translat Res Resp Med, IRBLleida, Lleida, Spain

[5] Hosp Universitari Germans Trias i Pujol, Resp Dept, Barcelona, Spain

[6] Hosp Univ Araba, Serv Invest OSI, IIS Bioaraba, Vitoria-gasteiz, Spain

[7] Hosp Univ Cruces, Serv Neumol, Bizkaia, Spain

[8] Hosp Univ Guadalajara, Resp Dept, Guadalajara, Spain

[9] Univ Autonoma Barcelona, Hosp Universitari Parc Tauli Inst Invest Innovacio, Resp & Sleep Dept, Barcelona, Spain

[10] Hosp Univ Burgos, Resp Dept, Burgos, Spain

[11] Hosp San Pedro Alcantara, Resp Dept, Caceres, Spain

[12] Hosp Univ Son Espases, Inst Invest Sanitaria Palma, Resp Serv, Clin Anal, Palma De Mallorca, Spain

[13] Hosp St Creu i St Pau, Dept Resp Med, Sleep Unit, Barcelona, Spain

[14] Hosp Gen Univ Albacete, Resp Dept, Albacete, Spain

[15] Hosp Clin Barcelona, Resp Dept, Barcelona, Spain

[16] Hosp Universitari St Joan Alacant, Resp Dept, Alicante, Spain

[17] Natl Univ Singapore, Cardiovasc Res Inst, Singapore, Singapore

[18] Flinders Univ S Australia, Adelaide Inst Sleep Hlth, Coll Med & Publ Hlth, Adelaide, SA, Australia

[19] Univ Lausanne, Lausanne Univ Hosp, Pulm Dept, Lausanne, Switzerland

来源：

FRONTIERS IN MEDICINE | 2022年 / 9卷

关键词：

acute coronary syndrome; cardiovascular disease; obstructive sleep apnea; precision medicine; respiratory polygraphy; OBSTRUCTIVE SLEEP-APNEA; POSITIVE AIRWAY PRESSURE; OUTCOMES; POPULATION; MODELS;

D O I：

10.3389/fmed.2022.870906

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

IntroductionObstructive sleep apnea (OSA) severity is based on the apnea-hypopnea index (AHI). The AHI is a simplistic measure that is inadequate for capturing disease severity and its consequences in cardiovascular diseases (CVDs). Deleterious effects of OSA have been suggested to influence the prognosis of specific endotypes of patients with acute coronary syndrome (ACS). We aim to identify respiratory polygraphy (RP) patterns that contribute to identifying the risk of recurrent cardiovascular events in patients with ACS. MethodsPost hoc analysis of the ISAACC study, including 723 patients admitted for a first ACS (NCT01335087) in which RP was performed. To identify specific RP patterns, a principal component analysis (PCA) was performed using six RP parameters: AHI, oxygen desaturation index, mean and minimum oxygen saturation (SaO(2)), average duration of events and percentage of time with SaO(2) < 90%. An independent HypnoLaus population-based cohort was used to validate the RP components. ResultsFrom the ISAACC study, PCA showed that two RP components accounted for 70% of the variance in the RP data. These components were validated in the HypnoLaus cohort, with two similar RP components that explained 71.3% of the variance in the RP data. The first component (component 1) was mainly characterized by low mean SaO(2) and obstructive respiratory events with severe desaturation, and the second component (component 2) was characterized by high mean SaO(2) and long-duration obstructive respiratory events without severe desaturation. In the ISAACC cohort, component 2 was associated with an increased risk of recurrent cardiovascular events in the third tertile with an adjusted hazard ratio (95% CI) of 2.44 (1.07 to 5.56; p-value = 0.03) compared to first tertile. For component 1, no significant association was found for the risk of recurrent cardiovascular events. ConclusionA RP component, mainly characterized by intermittent hypoxemia, is associated with a high risk of recurrent cardiovascular events in patients without previous CVD who have suffered a first ACS.

引用

页数：10

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