title: Sleep apnea prevalence in acute myocardial infarction--the Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study.
abstract: BACKGROUND
  While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients.
  
  
  METHODS
  We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 h post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (<5 events/h), mild SA (5-15 events/h), moderate SA (15-30 events/h), and severe SA (≥ 30 events/h).
  
  
  RESULTS
  Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥ 5 events/h, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6 AM to 12 PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12 AM to 6 AM (all p<0.05).
  
  
  CONCLUSIONS
  There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6 AM and noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.
authors: Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Ondrej
authors: O
authors: Ludka
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
authors: Radka
authors: R
authors: Stepanova
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
authors: Martina
authors: M
authors: Vyskocilova
authors: Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Lujza
authors: L
authors: Galkova
authors: Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Monika
authors: M
authors: Mikolaskova
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
authors: Milos
authors: M
authors: Belehrad
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
authors: Jana
authors: J
authors: Kostalova
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Zuzana
authors: Z
authors: Mihalova
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Adela
authors: A
authors: Drozdova
authors: Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Jiri
authors: J
authors: Hlasensky
authors: Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Michal
authors: M
authors: Gacik
authors: Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Lucie
authors: L
authors: Pudilova
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Department of Cardiovascular Disease, St. Anne's University Hospital, Brno, Czech Republic.
authors: Tereza
authors: T
authors: Mikusova
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Department of Cardiovascular Disease, St. Anne's University Hospital, Brno, Czech Republic.
authors: Blanka
authors: B
authors: Fischerova
authors: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA.
authors: Fatima
authors: F
authors: Sert-Kuniyoshi
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA.
authors: Virend K
authors: VK
authors: Somers
authors: Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors: Jindrich
authors: J
authors: Spinar
authors: International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Department of Cardiovascular Disease, St. Anne's University Hospital, Brno, Czech Republic; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA. Electronic address: Kara.Tomas@mayo.edu.
authors: Tomas
authors: T
authors: Kara
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D013997:Time Factors
keywords: Acute myocardial infarction; Day–night variation; Prevalence; Sleep apnea