Impact of obstructive sleep apnea on the occurrence of restenosis after elective percutaneous coronary intervention in ischemic heart disease.
BACKGROUND
There is growing evidence that obstructive sleep apnea is associated with coronary artery disease. However, there are no data on the course of coronary stenosis after percutaneous coronary intervention in patients with obstructive sleep apnea.


OBJECTIVE
To determine whether sleep apnea is associated with increased late lumen loss and restenosis after percutaneous coronary intervention.


METHODS
78 patients with coronary artery disease who underwent elective percutaneous coronary intervention were divided in 2 groups: 43 patients with an apnea hypopnea - Index < 10/h (group I) and 35 pt. with obstructive sleep apnea and an AHI > 10/h (group II). Late lumen loss, a marker of restenosis, was determined using quantitative coronary angiography after 6.9 +/- 3.1 months.


RESULTS
Angiographic restenosis (>50% luminal diameter), was present in 6 (14%) of group I and in 9 (25%) of group II (p = 0.11). Late lumen loss was significant higher in pt. with an AHI > 10/h (0.7 +/- 0.69 mm vs. 0.38 +/- 0.37 mm, p = 0.01). Among these 35 patients, 21(60%) used their CPAP devices regularly. There was a marginally lower late lumen loss in treated patients, nevertheless, this difference did not reach statistical significance (0.57 +/- 0.47 mm vs. 0.99 +/- 0.86 mm, p = 0.08). There was no difference in late lumen loss between treated patients and the group I (p = 0.206).


CONCLUSIONS
In summary, patients with OSA and coronary artery disease have a higher degree of late lumen loss, which is a marker of restenosis and vessel remodeling after elective percutaneous intervention.
Department of Cardiology, Pneumology and Angiology University Düsseldorf , 40225 Düsseldorf, Germany. Steinest@uni-duesseldorf.de
Stephan
S
Steiner
Per O
PO
Schueller
Marcus G
MG
Hennersdorf
Dominik
D
Behrendt
Bodo E
BE
Strauer
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D045422:Continuous Positive Airway Pressure; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000209:etiology / Q000628:therapy; D023903:Coronary Restenosis / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy