title: High risk for sleep apnea in the Berlin questionnaire and coronary artery disease.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) affects up to 30% of the adult population and is a risk factor for coronary artery disease (CAD). The diagnostic process, involving polysomnography, may be complex. Berlin questionnaire (BQ) is a validated and economical screening tool.
  
  
  OBJECTIVE
  The aim of this study was to assess the performance of the BQ for the diagnosis of OSA in individuals with angina complaints.
  
  
  METHODS
  Patients undergoing diagnostic cineangiography, portable type III polysomnography to determine the apnea-hypopnea index (AHI), and who answered the BQ were included. We excluded patients older than 65 years that were smokers, diabetics, and morbidly obese. High risk for OSA was based on positive responses in two of three symptom criteria of the BQ. CAD was defined by the presence of >50% lesion in coronary arteries.
  
  
  RESULTS
  In 57 included cases, high risk in the BQ indicates significant odds ratio [95% confidence interval] for the presence of CAD (4.5[1.03-19.25], P = 0.045), adjusted for usual confounders: gender, age, and body mass index. The sensitivity and the specificity of BQ for CAD were 70% and 48%, respectively; the positive and negative predictive values are 56% and 64%.
  
  
  CONCLUSIONS
  In conclusion, simple questionnaire-based diagnostic tools can be included in the screening procedures of patients with angina to detect the need for further OSA evaluation. In conclusion, the BQ is an effective instrument for this purpose.
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Denis
authors.initials: D
authors.lastname: Martinez
authors.forename: Roberto Pacheco
authors.initials: RP
authors.lastname: da Silva
authors.forename: Cristini
authors.initials: C
authors.lastname: Klein
authors.forename: Cintia Zappe
authors.initials: CZ
authors.lastname: Fiori
authors.forename: Daniela
authors.initials: D
authors.lastname: Massierer
authors.forename: Cristiane Maria
authors.initials: CM
authors.lastname: Cassol
authors.forename: Angelo Jose Gonçalves
authors.initials: AJ
authors.lastname: Bos
authors.forename: Miguel
authors.initials: M
authors.lastname: Gus
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis / Q000453:epidemiology; D001604:Berlin; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008432:Mathematical Computing; D008875:Middle Aged; D017286:Polysomnography / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires