Suspicion of obstructive sleep apnea by Berlin Questionnaire predicts events in patients with acute coronary syndrome.
BACKGROUND
From a mechanistic standpoint, obstructive sleep apnea (OSA) may further disturb cardiovascular homeostasis in the setting of acute coronary syndrome (ACS).


OBJECTIVE
We sought to investigate if a standardized clinical diagnosis of OSA, in acute coronary syndrome patients, predicts the risk of cardiovascular events during hospitalization.


METHODS
In a prospective cohort study, a group of 200 patients diagnosed with ACS between September 2005 and November 2007 were stratified by the Berlin Questionnaire (BQ) regarding the risk for OSA (high or low risk). We tested if the subgroup of high risk for OSA was prone to a higher frequency of cardiovascular events. The primary endpoint evaluated was a composite outcome of cardiovascular death, recurrent cardiac ischemic events, acute pulmonary edema and stroke during hospitalization.


RESULTS
Ninety four (47%) patients assessed by the BQ were likely to have OSA. High risk for OSA was associated with a non-significant higher mortality (4.25% vs 0.94%; p=0.189), but a significant higher incidence of composite cardiovascular events (18.08% vs 6.6%; p=0.016). In the logistic regression model, multivariate predictors of composite cardiovascular events were age (OR= 1.048; 95% CI 1.008 to 1.090; p=0.019), left ventricular ejection fraction (OR= 0.954; 95% CI 0.920 to 0.989; p=0.010), and higher risk for OSA (OR= 3.657; 95% CI 1.216 to 10.996; p=0.021).


CONCLUSIONS
The use of a simple and validated questionnaire (BQ) to identify patients with higher risk for OSA may help in the prediction of cardiovascular outcome during hospitalization. Moreover, our data suggests that OSA is very common in patients with ACS.
Jesus
Eryca Vanessa S de
EV
Departamento de Cardiologia, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
Dias-Filho
Euvaldo B
EB
Mota
Bethania de M
Bde M
Souza
Luiz de
Ld
Marques-Santos
Celi
C
Rocha
João Bosco G
JB
Oliveira
Joselina L M
JL
Sousa
Antônio C S
AC
Barreto-Filho
José Augusto
JA
D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000209:etiology*; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis; D011795:Surveys and Questionnaires