title: Predictors of obstructive sleep apnoea in patients admitted for acute coronary syndrome.
abstract: Identifying undiagnosed obstructive sleep apnoea (OSA) patients in cardiovascular clinics could improve their management. Aiming to build an OSA predictive model, a broad analysis of clinical variables was performed in a cohort of acute coronary syndrome (ACS) patients.Sociodemographic, anthropometric, life-style and pharmacological variables were recorded. Clinical measures included blood pressure, electrocardiography, echocardiography, blood count, troponin levels and a metabolic panel. OSA was diagnosed using respiratory polygraphy. Logistic regression models and classification and regression trees were used to create predictive models.A total of 978 patients were included (298 subjects with apnoea-hypopnoea index (AHI) <15 events·h-1and 680 with AHI ≥15 events·h-1). Age, BMI, Epworth sleepiness scale, peak troponin levels and use of calcium antagonists were the main determinants of AHI ≥15 events·h-1(C statistic 0.71; sensitivity 94%; specificity 24%). Age, BMI, blood triglycerides, peak troponin levels and Killip class ≥II were determinants of AHI ≥30 events·h-1(C statistic of 0.67; sensitivity 31%; specificity 86%).Although a set of variables associated with OSA was identified, no model could successfully predict OSA in patients admitted for ACS. Given the high prevalence of OSA, the authors propose respiratory polygraphy as a to-be-explored strategy to identify OSA in ACS patients.
authors.affiliation: Respiratory Dept, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|Both authors contributed equally to this study.
authors.forename: Jordi
authors.initials: J
authors.lastname: de Batlle
authors.affiliation: Respiratory Dept, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|Both authors contributed equally to this study.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Turino
authors.affiliation: Respiratory Dept, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Sánchez-de-la-Torre
authors.affiliation: Respiratory Dept, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Abad
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.|Medicine Dept, OSI Araba University Hospital, UPV, BioAraba Institute, Vitoria, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Duran-Cantolla
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, Flinders University, Adelaide, Australia.
authors.forename: R Douglas
authors.initials: RD
authors.lastname: McEvoy
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, Flinders University, Adelaide, Australia.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Antic
authors.affiliation: Respiratory Dept, Hospital Universitario de Guadalajara, Guadalajara, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Mediano
authors.affiliation: Respiratory Dept, Hospital de Cruces, Bilbao, Spain.
authors.forename: Valentín
authors.identifier: 0000-0003-1124-7108
authors.initials: V
authors.lastname: Cabriada
authors.affiliation: Respiratory Dept, Hospital Parc Taulí, Sabadell, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Masdeu
authors.affiliation: Respiratory Dept, Hospital General Yagüe, Burgos, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Teran
authors.affiliation: Unit of Bioestatistics and Epidemiology, IRBLleida, Lleida, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Valls
authors.affiliation: Respiratory Dept, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
authors.affiliation: Respiratory Dept, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain sanchezdelatorre@gmail.com.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sánchez-de-la-Torre
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D000886:Anthropometry; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy*; D013030:Spain / Q000453:epidemiology; D014336:Troponin / Q000097:blood
chemical_list: D014336:Troponin