title: Impact of obstructive sleep apnea in recruitment of coronary collaterality during inaugural acute myocardial infarction.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) may lead to myocardial preconditioning by increasing coronary collateral vessel recruitment in patients with acute coronary occlusion.
  
  
  OBJECTIVE
  To determine the relationship between the severity of obstructive sleep apnea and coronary collaterality during acute myocardial infarction.
  
  
  METHODS
  This study prospectively included 71 patients with an inaugural myocardial infarction who had undergone a coronary angiography within 24h of onset. All patients underwent an overnight polygraph before discharge and were classified according to the apnea-hypopnea index (AHI). Coronary collaterals were scored by visual analyses and according to the Rentrop grading system.
  
  
  RESULTS
  Mean age was 59±11years and 83% of patients were men. All patients had complete or subtotal occlusion of the infarct-related artery. After the sleep study, patients were divided into two groups: 25 were suffering from OSA (AHI>15/h). Patients with OSA showed better collateral vessel development (Rentrop score≥1) compared to non-OSA patients (68 vs. 41%, P=0.032). AHI was significantly higher in patients with developed coronary collaterals (Rentrop≥1) compared to those without collaterality (17.74±13.2 vs. 12.24±10.9, P=0.025).
  
  
  CONCLUSIONS
  Coronary collateral development may be increased in OSA patients who are presenting with a first myocardial infarction.
authors.affiliation: Department of cardiology, Charles Nicolle University Hospital, 1006 Bab Saadoun, Tunisia. Electronic address: halfaouine2002@yahoo.fr.
authors.forename: H
authors.initials: H
authors.lastname: Ben Ahmed
authors.affiliation: Department of cardiology, Charles Nicolle University Hospital, 1006 Bab Saadoun, Tunisia. Electronic address: boussaidhoussem@hotmail.fr.
authors.forename: H
authors.initials: H
authors.lastname: Boussaid
authors.affiliation: Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: salma.longo@yahoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Longo
authors.affiliation: Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: ramihenia@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Tlili
authors.affiliation: Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: fazaasamia@yahoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Fazaa
authors.affiliation: Department of cardiology, Charles Nicolle University Hospital, 1006 Bab Saadoun, Tunisia. Electronic address: baccar.hedi@yahoo.fr.
authors.forename: H
authors.initials: H
authors.lastname: Baccar
authors.affiliation: Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: rachidboujnah@yahoo.fr.
authors.forename: M R
authors.initials: MR
authors.lastname: Boujnah
mesh_terms: D000328:Adult; D000368:Aged; D003097:Collateral Circulation / Q000502:physiology*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D017286:Polysomnography; D011379:Prognosis; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D015912:Thrombolytic Therapy
keywords: Apnea–hypopnea index; Apnée obstructive du sommeil; Circulation coronaire; Coronary circulation; Index apnée–hypopnée; Infarctus du myocarde; Myocardial infarction; Obstructive sleep apnea