title: Obstructive sleep apnea in patients admitted for acute myocardial infarction. Prevalence, predictors, and effect on microvascular perfusion.
abstract: BACKGROUND
  We investigated the prevalence and predictors of obstructive sleep apnea (OSA) in patients admitted to the hospital for acute myocardial infarction and whether OSA has any association with microvascular perfusion after primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Recruited patients were scheduled to undergo an overnight sleep study between 2 and 5 days after primary PCI. An apnea-hypopnea index (AHI) of > or = 15 was considered diagnostic of OSA. Impaired microvascular perfusion after primary PCI was defined as an ST-segment resolution of < or = 70%, myocardial blush grade 0 or 1, or a corrected Thrombolysis in Myocardial Infarction (TIMI) [antegrade flow scale] frame count > 28.
  
  
  RESULTS
  Sleep study was performed in 120 patients and completed in 105 patients (study cohort, mean age 53 +/- 10 years, male 98%) with uncomplicated myocardial infarction. An AHI was > or = 15 in 69 patients (OSA-positive), giving a prevalence of 65.7%. Diabetes mellitus was found to be a significant risk factor for OSA (odds ratio, 2.86; 95% confidence interval, 1.06 to 8.24; p = 0.033). There were no differences between OSA-positive and OSA-negative groups with regard to the percentage of patients with < or = 70% ST-segment resolution (73% vs 64%, respectively; p = 0.411), myocardial blush grade 0 or 1 (39.1% vs 38.9%, respectively; p = 1.000), or corrected TIMI frame count > 28 (21.7% vs 25.0%, respectively; p = 0.807).
  
  
  CONCLUSIONS
  We found a high prevalence of previously undiagnosed OSA in patients admitted with acute myocardial infarction. Diabetes mellitus was independently associated with OSA. No evidence indicated that OSA is associated with impaired microvascular perfusion after primary PCI.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; The Heart Institute, National University Hospital, Singapore. Electronic address: mdclchr@nus.edu.sg.
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Medicine, National University Hospital, Singapore.
authors.forename: See-Meng
authors.initials: SM
authors.lastname: Khoo
authors.affiliation: Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Bee-Choo
authors.initials: BC
authors.lastname: Tai
authors.affiliation: The Heart Institute, National University Hospital, Singapore.
authors.forename: Eric Y
authors.initials: EY
authors.lastname: Chong
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Cindy
authors.initials: C
authors.lastname: Lau
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yemon
authors.initials: Y
authors.lastname: Than
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Dong-Xia
authors.initials: DX
authors.lastname: Shi
authors.affiliation: The Heart Institute, National University Hospital, Singapore.
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Lee
authors.affiliation: The Heart Institute, National University Hospital, Singapore.
authors.forename: Anand
authors.initials: A
authors.lastname: Kailasam
authors.affiliation: The Heart Institute, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Low
authors.affiliation: The Heart Institute, National University Hospital, Singapore.
authors.forename: Swee-Guan
authors.initials: SG
authors.lastname: Teo
authors.affiliation: The Heart Institute, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Huay-Cheem
authors.initials: HC
authors.lastname: Tan
mesh_terms: D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015331:Cohort Studies; D015897:Comorbidity; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D017286:Polysomnography; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D018709:Statistics, Nonparametric; D015996:Survival Rate