title: Impact of OSA on cardiovascular events after coronary artery bypass surgery.
abstract: BACKGROUND
  The impact of OSA on new cardiovascular events in patients undergoing coronary artery bypass graft (CABG) surgery is poorly explored.
  
  
  METHODS
  Consecutive patients referred for CABG underwent clinical evaluation and standard polysomnography in the preoperative period. CABG surgery data, including percentage of off-pump and on-pump CABG, number of grafts, and intraoperative complications, were collected. The primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated revascularization, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina, and arrhythmias. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) after CABG.
  
  
  RESULTS
  We studied 67 patients (50 men; mean age, 58 ± 8 years; mean BMI, 28.5 ± 4.1 kg/m2). OSA (apnea-hypopnea index ≥ 15 events/h) was present in 56% of the population. The patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. In contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up. OSA was an independent factor associated with the occurrence of MACCE, repeated revascularization, typical angina, and atrial fibrillation in the multivariate analysis.
  
  
  CONCLUSIONS
  OSA is independently associated with a higher rate of long-term cardiovascular events after CABG and may have prognostic and economic significance in CABG surgery.
authors.affiliation: Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo; Hypertension Unit, University of São Paulo Medical School, São Paulo.
authors.forename: Carlos Henrique G
authors.initials: CHG
authors.lastname: Uchôa
authors.affiliation: Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo.
authors.forename: Naury de Jesus
authors.initials: NJ
authors.lastname: Danzi-Soares
authors.affiliation: Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo.
authors.forename: Flávia S
authors.initials: FS
authors.lastname: Nunes
authors.affiliation: Physicobiology Department, Federal University, São Paulo.
authors.forename: Altay A L
authors.initials: AAL
authors.lastname: de Souza
authors.affiliation: Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo.
authors.forename: Flávia B
authors.initials: FB
authors.lastname: Nerbass
authors.affiliation: Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Pernambuco, Brazil.
authors.forename: Rodrigo P
authors.initials: RP
authors.lastname: Pedrosa
authors.affiliation: Clinical Unit of Chronic Coronary Heart Disease, Heart Institute (InCor), University of São Paulo Medical School, São Paulo.
authors.forename: Luiz Antonio M
authors.initials: LAM
authors.lastname: César
authors.affiliation: Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
authors.affiliation: Hypertension Unit, University of São Paulo Medical School, São Paulo; Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo. Electronic address: luciano.drager@incor.usp.br.
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D002561:Cerebrovascular Disorders / Q000209:etiology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D013997:Time Factors