Impact of Sleep-Disordered Breathing on Long-Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention.
Sleep-disordered breathing (SDB) has been recognized as an important risk factor for cardiovascular diseases; however, the impact of SDB on long-term outcomes in patients with acute coronary syndrome has not been fully evaluated.



We performed overnight cardiorespiratory monitoring of 241 patients with acute coronary syndrome who were successfully treated with primary percutaneous coronary intervention between January 2005 and December 2008. The presence of SDB was defined as apnea-hypopnea index ≥5 events per hour. The end point was incidence of major adverse cardiocerebrovascular events, defined as a composite of all-cause death, recurrence of acute coronary syndrome, nonfatal stroke, and hospital admission for congestive heart failure. Patients were followed for a median period of 5.6 years. Among the 241 patients who were finally enrolled, comorbidity of SDB with acute coronary syndrome was found in 126 patients (52.3%). The cumulative incidence of major adverse cardiocerebrovascular events was significantly higher in patients with SDB than in those without SDB (21.4% versus 7.8%, P=0.006). Multivariable analysis revealed that the presence of SDB was a significant predictor of major adverse cardiocerebrovascular events (hazard ratio 2.28, 95% CI 1.06-4.92; P=0.035).



The study's results showed that the presence of SDB among patients with acute coronary syndrome following primary percutaneous coronary intervention is associated with a higher incidence of major adverse cardiocerebrovascular events during long-term follow-up.
Department of Cardiology, Kobe Central Hospital, Kobe, Japan mazakinn@gmail.com.
Toru
T
Mazaki
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Takatoshi
T
Kasai
Department of Cardiology, Fukuoka Sanno Hospital, Fukuoka, Japan.
Hiroyoshi
H
Yokoi
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Shoichi
S
Kuramitsu
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Kyohei
K
Yamaji
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Takashi
T
Morinaga
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Hisaki
H
Masuda
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Shinichi
S
Shirai
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Kenji
K
Ando
D054058:Acute Coronary Syndrome / Q000150:complications / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012008:Recurrence; D012044:Regression Analysis; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000401:mortality; D020521:Stroke / Q000209:etiology / Q000401:mortality
acute coronary syndrome; percutaneous coronary intervention; prognosis; sleep‐disordered breathing