Sleep apnoea syndrome and the extent of atherosclerotic lesions in middle-aged men with myocardial infarction.
BACKGROUND
To determine whether extended atherosclerotic lesions are correlated to the presence of sleep breathing disorders.


METHODS



METHODS
A prospective clinical study.


METHODS
A tertiary regional referral center.


METHODS
40 male patients < or =65 years consecutively admitted to the cardiac care unit for an acute myocardial infarction with serous creatinine phosphokinase (CPK) > or =350 IU/l and a CPK-MB fraction > or =10%. Exclusion criteria were: cardiac surgery on emergency, stroke, major neurological and/or psychiatric disturbances, alcohol consumption >50 g/day, toxicomania, clinical or biological hypothyroidism, clinical acromegaly and chronic obstructive pulmonary disease.


METHODS
Duplex ultrasonography was performed on carotid arteries, femoral arteries and their bifurcations. An overnight polysomnography was performed after hospital discharge. Patients with an apnoea index >5/hour or apnoea-hypopnea index >10/hour of sleep are considered to have sleep apnoea syndrome (SAS). Patients with additive peripheral atherosclerotic lesions are compared to patients with normal carotid and femoral arteries, regarding to standard cardiovascular risk factors and apnoeas or hypopnoeas during sleep.


RESULTS
Duplex revealed in 18 patients carotid and/or femoral atherosclerotic lesions. The prevalence of SAS in patients with at least one peripheral arterial lesion was significantly higher (61% vs 18%, p<0.01). A nearly significant difference was also noted in patients with carotid lesions alone compared to those with normal carotid arteries (57% vs 27%, p=0.06).


CONCLUSIONS
These results suggest a possible link between sleep breathing disorders and the pathogenesis of atherosclerotic lesions.
Aboyans
V
V
Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren's University Hospital, Limoges, France.
Lacroix
P
P
Virot
P
P
Tapie
P
P
Cassat
C
C
Rambaud
G
G
Laskar
M
M
Bensaid
J
J
D000368:Aged; D001161:Arteriosclerosis / Q000209:etiology / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000150:complications; D005263:Femoral Artery / Q000473:pathology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology; D017286:Polysomnography; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications*; D018616:Ultrasonography, Doppler, Duplex