title: The influence of timing of polysomnography on diagnosis of obstructive sleep apnea in patients presenting with acute myocardial infarction and stable coronary artery disease.
abstract: BACKGROUND
  We aimed to determine if timing of polysomnography (PSG) influences the diagnosis of obstructive sleep apnea (OSA) in acute myocardial infarction (AMI) or stable coronary artery disease (CAD).
  
  
  METHODS
  A total of 160 patients admitted with AMI or stable CAD were consecutively recruited for either in-hospital (n=80) or postdischarge (n=80) PSG.
  
  
  RESULTS
  The median time from admission to PSG for the in-hospital and postdischarge groups was 1 day and 17 days, respectively (P<.001). Overall, 59 patients (36.9%) were diagnosed with OSA (apnea-hypopnea index [AHI] > or = 15), and they were more likely to have diabetes mellitus (DM), hypertension, hyperlipidemia, chronic renal failure, and a greater body mass index (BMI) (P<.05 for all). The diagnosis of OSA was significantly higher (P=.037) in patients who had a PSG performed as an inpatient than those who had a PSG as an outpatient. There was a significant interaction between clinical presentation and the effect of PSG timing on the diagnosis of OSA (P=.003). For the patients presenting with AMI but not those with stable CAD, in-hospital PSG was an independent predictor of OSA (adjusted odds ratio, 3.84 [95% confidence interval, 1.42-10.41]; P=.008).
  
  
  CONCLUSIONS
  The timing of PSG influenced the diagnosis of OSA in patients who presented with AMI but not in those who presented with stable CAD.
authors.affiliation: Department of Cardiology, National University Heart Centre, Singapore.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Low
authors.forename: Wei-Zhen
authors.initials: WZ
authors.lastname: Hong
authors.forename: Bee-Choo
authors.initials: BC
authors.lastname: Tai
authors.forename: Thet
authors.initials: T
authors.lastname: Hein
authors.forename: See-Meng
authors.initials: SM
authors.lastname: Khoo
authors.forename: Adeline Y
authors.initials: AY
authors.lastname: Tan
authors.forename: Mark Y
authors.initials: MY
authors.lastname: Chan
authors.forename: Mark
authors.initials: M
authors.lastname: Richards
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications*; D010045:Outpatients; D010351:Patient Discharge; D017286:Polysomnography / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors
keywords: Diagnosis; Myocardial infarction; Myocardial stunning; Polysomnography; Sleep apnea; Stable coronary artery disease