Association of obstructive sleep apnoea with cardiovascular events in women and men with acute coronary syndrome.

Autor:	Wang X; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Fan J; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Guo R; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Hao W; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Gong W; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Yan Y; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Zheng W; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Ai H; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Que B; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Hu D; Department of Cardiology & Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, China., Ma C; Arrhythmia Center, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Ma X; Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA., Somers VK; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA., Nie S; Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China spnie@ccmu.edu.cn.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2023 Jan 27; Vol. 61 (1). Date of Electronic Publication: 2023 Jan 27 (Print Publication: 2023).
DOI:	10.1183/13993003.01110-2022
Abstrakt:	Background: The impact of sex on the association of obstructive sleep apnoea (OSA) with recurrent cardiovascular events following acute coronary syndrome (ACS) remains uncertain. This study sought to examine the association between OSA and long-term cardiovascular outcomes in women and men with ACS. Methods: In this prospective cohort study, we recruited 2160 ACS patients undergoing portable sleep monitoring between June 2015 and January 2020. The primary end-point was major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischaemia-driven revascularisation or hospitalisation for unstable angina or heart failure. Results: After exclusion of patients with failed sleep studies, central sleep apnoea, regular continuous positive airway pressure therapy and loss of follow-up, 1927 patients were enrolled. Among them, 298 (15.5%) were women and 1014 (52.6%) had OSA (apnoea-hypopnoea index ≥15 events·h -1 ). The prevalence of OSA was 43.0% and 54.4% in women and men, respectively. In 4339 person-years (median 2.9 years, interquartile range 1.5-3.6 years), the cumulative incidence of MACCE was significantly higher in OSA versus non-OSA groups in the overall population (22.4% versus 17.7%; adjusted hazard ratio (HR) 1.29, 95% CI 1.04-1.59; p=0.018). OSA was associated with greater risk of MACCE in women (28.1% versus 18.8%; adjusted HR 1.68, 95% CI 1.02-2.78; p=0.042), but not in men (21.6% versus 17.5%; adjusted HR 1.22, 95% CI 0.96-1.54; p=0.10). No significant interaction was noted between sex and OSA for MACCE (interaction p=0.32). The incremental risk in women was attributable to higher rates of hospitalisation for unstable angina and ischaemia-driven revascularisation. Conclusions: In hospitalised ACS patients, OSA was associated with increased risk of subsequent events, particularly among women. Female patients with ACS should not be neglected for OSA screening and dedicated intervention studies focusing on women with ACS and comorbid OSA should be prioritised. Competing Interests: Conflict of interest: Changsheng Ma reports honoraria from Bristol-Myers Squibb (BMS), Pfizer, Johnson & Johnson, Boehringer Ingelheim (BI), Bayer and AstraZeneca for giving lectures. Shaoping Nie reports research grants (paid to institution) from Boston Scientific, Abbott, Jiangsu Hengrui Pharmaceuticals, China Resources Sanjiu Medical & Pharmaceuticals and East China Pharmaceuticals. Virend K. Somers has served as a consultant for Respicardia, Bayer, Lilly, Resmed and Jazz Pharmaceuticals, and serves on the scientific advisory board for Sleep Number. The rest of the authors have no relevant relationships to disclose. (Copyright ©The authors 2023.)
Databáze:	MEDLINE
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