title: Impact of Obstructive Sleep Apnea on the Levels of Placental Growth Factor (PlGF) and Their Value for Predicting Short-Term Adverse Outcomes in Patients with Acute Coronary Syndrome.
abstract: BACKGROUND
  Placental growth factor (PlGF) induces angiogenesis and promotes tissue repair, and plasma PlGF levels change markedly during acute myocardial infarction (AMI). Currently, the impact of obstructive sleep apnea (OSA) in patients with AMI is a subject of debate. Our objective was to evaluate the relationships between PlGF levels and both the severity of acute coronary syndrome (ACS) and short-term outcomes after ACS in patients with and without OSA.
  
  
  METHODS
  A total of 538 consecutive patients (312 OSA patients and 226 controls) admitted for ACS were included in this study. All patients underwent polygraphy in the first 72 hours after hospital admission. The severity of disease and short-term prognoses were evaluated during the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence immunoassay.
  
  
  RESULTS
  Patients with OSA were significantly older and more frequently hypertensive and had higher BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with patients without OSA (19.9 pg/mL, interquartile range: 16.6-24.5 pg/mL; 18.5 pg/mL, interquartile range: 14.7-22.7 pg/mL; p<0.001), and a higher apnea-hypopnea index (AHI) was associated with higher PlGF concentrations (p<0.003). Patients with higher levels of PlGF had also an increased odds ratio for the presence of 3 or more diseased vessels and for a Killip score>1, even after adjustment.
  
  
  CONCLUSIONS
  The results of this study show that in patients with ACS, elevated plasma levels of PlGF are associated with the presence of OSA and with adverse outcomes during short-term follow-up.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01335087.
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Barcelo
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Josep Miquel
authors.initials: JM
authors.lastname: Bauça
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Aina
authors.initials: A
authors.lastname: Yañez
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Fueyo
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Gomez
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Monica
authors.initials: M
authors.lastname: de la Peña
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Pierola
authors.affiliation: Hospital Universitari Son Espases, Palma, Illes Balears, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sanchez-de-la-Torre
authors.affiliation: Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Abad
authors.affiliation: Hospital Universitario de Guadalajara, Guadalajara, Castilla-La Mancha, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Mediano
authors.affiliation: Hospital Universitario Cruces, Bilbao, Basque Country, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Amilibia
authors.affiliation: Hospital Parc Taulí, Sabadell, Catalonia, Spain.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Masdeu
authors.affiliation: Hospital General Yagüe, Burgos, Castilla-León, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Teran
authors.affiliation: Hospital Clínic, Barcelona, Catalonia, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Montserrat
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Mayos
authors.affiliation: Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Sanchez-de-la-Torre
authors.affiliation: Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072483:Placenta Growth Factor; D011257:Pregnancy Proteins / Q000097:blood*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor