title: Prevalence of Sleep-Disordered Breathing and Patient Characteristics in a Coronary Artery Disease Cohort Undergoing Cardiovascular Rehabilitation.
abstract: OBJECTIVE
  Coronary artery disease (CAD) is a leading cause of death and identification of risk factors for CAD is crucial. One such potential risk factor is sleep-disordered breathing (SDB). This prospective cohort study investigated the prevalence of SDB and determined risk factors for the presence of SDB in a large CAD cohort undergoing cardiac rehabilitation.
  
  
  METHODS
  A total of 1425 patients with confirmed CAD starting rehabilitation were screened for SDB using cardiorespiratory polygraphy (n = 921) or polygraphy plus pulse oximetry (n = 484).
  
  
  RESULTS
  A total of 1408 patients were included; 69.5% were male, 78% had acute coronary syndrome, and 22% had stable CAD. The prevalence of SDB (apnea-hypopnea index [AHI] ≥5/h) was 83%. Moderate to severe SDB (AHI ≥15/h) was present in 53%. Up to 70% of coronary artery bypass graft (CABG) recipients had an AHI ≥15/h versus 33% of those who had not undergone CABG. SDB severity did not vary significantly in patients with stable CAD or on the basis of left ventricular ejection fraction. SDB was more severe and the frequency of oxygen desaturation was higher in men than in women. Multivariate logistic regression identified age, sex, body mass index, and CABG as independent risk factors for severe SDB.
  
  
  CONCLUSIONS
  SDB is a highly prevalent comorbidity in patients with CAD, particularly those who have undergone CABG. These results strengthen existing associations and emphasize the importance of diagnosing and monitoring SDB in patients with CAD entering a cardiac rehabilitation program. Early diagnosis and intervention has the potential to have a beneficial effect on CAD prognosis.
authors.affiliation: Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (Drs Fox, Bitter, Horstkotte, and Oldenburg); Klinik Teutoburger Wald, Rehabilitation Facility of Deutsche Rentenversicherung Braunschweig-Hannover, Bad Rothenfelde, Germany (Drs Purucker and Holzhacker); Klinik im Kurpark, Private Rehabilitation Facility, Bad Rothenfelde, Germany (Dr Tebtmann); ResMed Germany Inc, Martinsried, Germany (Ms Graml and Dr Woehrle); and Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany (Dr Woehrle).
authors.forename: Henrik
authors.initials: H
authors.lastname: Fox
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Purucker
authors.forename: Isabelle
authors.initials: I
authors.lastname: Holzhacker
authors.forename: Ulrich
authors.initials: U
authors.lastname: Tebtmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Bitter
authors.forename: Dieter
authors.initials: D
authors.lastname: Horstkotte
authors.forename: Andrea
authors.initials: A
authors.lastname: Graml
authors.forename: Holger
authors.initials: H
authors.lastname: Woehrle
authors.forename: Olaf
authors.initials: O
authors.lastname: Oldenburg
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*