title: Effects of Ethnicity on the Prevalence of Obstructive Sleep Apnoea in Patients with Acute Coronary Syndrome: A Pooled Analysis of the ISAACC Trial and Sleep and Stent Study.
abstract: BACKGROUND
  Obstructive sleep apnoea (OSA) is an emerging risk factor for acute coronary syndrome (ACS). We sought to determine the effects of ethnicity on the prevalence of OSA in patients presenting with ACS who participated in an overnight sleep study.
  
  
  METHODS
  A pooled analysis using patient-level data from the ISAACC Trial and Sleep and Stent Study was performed. Using the same portable diagnostic device, OSA was defined as an apnoea-hypopnoea index of ≥15 events per hour.
  
  
  RESULTS
  A total of 1961 patients were analysed, including Spanish (53.6%, n=1050), Chinese (25.5%, n=500), Indian (12.0%, n=235), Malay (6.1%, n=119), Brazilian (1.7%, n=34) and Burmese (1.2%, n=23) populations. Significant differences in body mass index (BMI) were found among the various ethnic groups, averaging from 25.3kg/m2for Indians and 25.4kg/m2for Chinese to 28.6kg/m2for Spaniards. The prevalence of OSA was highest in the Spanish (63.1%), followed by the Chinese (50.2%), Malay (47.9%), Burmese (43.5%), Brazilian (41.2%), and Indian (36.1%) patients. The estimated odds ratio of BMI on OSA was highest in the Chinese population (1.17; 95% confidence interval: 1.10-1.24), but was not significant in the Spanish, Burmese or Brazilian populations. The area under the curve (AUC) for the Asian patients (ranging from 0.6365 to 0.6692) was higher than that for the Spanish patients (0.5161).
  
  
  CONCLUSIONS
  There was significant ethnic variation in the prevalence of OSA in patients with ACS. The magnitude of the effect of BMI on OSA was greater in the Chinese population than in the Spanish patients.
authors.affiliation: Department of Cardiology, National University Heart Centre, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore. Electronic address: christopher_koo@nuhs.edu.sg.
authors.forename: Chieh-Yang
authors.initials: CY
authors.lastname: Koo
authors.affiliation: Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRB Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors.forename: Alicia Sánchez
authors.initials: AS
authors.lastname: de la Torre
authors.affiliation: Department of Cardiology, National University Heart Centre, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.
authors.forename: Germaine
authors.initials: G
authors.lastname: Loo
authors.affiliation: Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRB Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors.forename: Manuel Sánchez-de-la
authors.initials: MS
authors.lastname: Torre
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing, China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Bio-Araba Research Institute, Araba University Hospital, Department of Medicine of Basque Country University, Vitoria-Gasteiz, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Duran-Cantolla
authors.affiliation: Department of Cardiology, Shanghai Chest Hospital, Shanghai, China.
authors.forename: Ruogu
authors.initials: R
authors.lastname: Li
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Mercé
authors.initials: M
authors.lastname: Mayos
authors.affiliation: Department of Cardiology, King George's Medical University, Lucknow, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Sethi
authors.affiliation: Respiratory Department, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Catalonia, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Abad
authors.affiliation: Hypertension Unit-Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Sofia F
authors.initials: SF
authors.lastname: Furlan
authors.affiliation: Respiratory Department, Hospital General Universitario de Albacete, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Coloma
authors.affiliation: No (1) 1000 bedded Defence Services General Hospital, Mingaladon, Yangon, Myanmar.
authors.forename: Thet
authors.initials: T
authors.lastname: Hein
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Hee-Hwa
authors.initials: HH
authors.lastname: Ho
authors.affiliation: Cardiac Medical Unit, The Grantham Hospital, Hong Kong.
authors.forename: Man-Hong
authors.initials: MH
authors.lastname: Jim
authors.affiliation: Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
authors.forename: Thun-How
authors.initials: TH
authors.lastname: Ong
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Bee-Choo
authors.initials: BC
authors.lastname: Tai
authors.affiliation: Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRB Lleida, Lleida, Spain.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Turino
authors.affiliation: Hypertension Unit-Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
authors.affiliation: Department of Cardiology, National University Heart Centre, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRB Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. Electronic address: febarbe.lleida.ics@gencat.cat.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbe
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology / Q000628:therapy; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology* / Q000628:therapy
keywords: Acute coronary syndrome; Obstructive sleep apnoea