title: Links between sleep disordered breathing, coronary atherosclerotic burden, and cardiac biomarkers in patients with stable coronary artery disease.
abstract: BACKGROUND
  Sleep disordered breathing (SDB) is highly prevalent in patients with cardiovascular disease, although it is not clear whether SDB has any link to coronary atherosclerotic burden in patients with stable coronary artery disease (CAD). This study sought to analyze the links between SDB, coronary atherosclerotic burden, and cardiac biomarkers in stable CAD patients.
  
  
  RESULTS
  We studied 83 consecutive patients who underwent coronary angiography or scheduled percutaneous coronary intervention. SDB was evaluated by an ambulatory polysomnographic monitoring device. Coronary atherosclerotic burden was evaluated by the Gensini score, and myocardial stress/injury were assessed by measuring plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high sensitivity troponin T (hs-TnT). Patients with an apnea hypopnea index (AHI)≧15 events/h (n=32) showed significantly higher Gensini score (35.7±38.0 vs 20.1±19.7, p=0.033) than those with AHI<15. The higher AHI group showed significantly higher NT-proBNP (275.8±402.6 pg/ml vs 131.9±146.3 pg/ml, p=0.047) and hs-TnT levels (0.011±0.005 ng/ml vs 0.008±0.003 ng/ml, p=0.015). Furthermore it was revealed that AHI significantly correlated with the Gensini score (r=0.253, p=0.036), NT-proBNP (r=0.266, p=0.027), and hs-TnT (r=0.274, p=0.023), and multiple stepwise linear regression analysis revealed that AHI (β=0.257, p=0.029) and history of smoking (β=0.244, p=0.038) were independently correlated with Gensini score among clinical and SDB-related parameters.
  
  
  CONCLUSIONS
  Severity of SDB has a significant link to the severity of coronary atherosclerotic burden, which also reflected elevated NT-proBNP and hs-TnT as silent myocardial ischemia and minute myocardial injury even in stable CAD patients.
authors.affiliation: Division of Cardiology, Nippon Medical School Chiba-Hokusoh Hospital, Chiba, Japan. t-inami@nms.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Otsuka
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Nakahisa
authors.initials: N
authors.lastname: Kimata
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohba
authors.forename: Chikao
authors.initials: C
authors.lastname: Ibuki
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D017286:Polysomnography; D012044:Regression Analysis; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein