Screening and treatment of obstructive sleep apnea in acute coronary syndrome. A randomized clinical trial
| Autor: | Tiong-Cheng Yeo, Chi-Hang Lee, Jenny P.C. Chong, Eugene Siang-Joo Tan, Ai-Ping Chua, Tun-Oo Han, Esther Hui-Ting Koh, Munirah Binte Abd Gani, Aye-Thandar Aung, William Kristanto, Shaffinaz Abd Rahman, Pipin Kojodjojo, Arthur Mark Richards, Siew Pang Chan, Adrian F. Low, Mark Y. Chan, Chieh-Yang Koo |
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| Rok vydání: | 2019 |
| Předmět: |
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medicine.medical_specialty Acute coronary syndrome medicine.medical_treatment Polysomnography Aftercare 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Natriuretic Peptide Brain medicine Clinical endpoint Humans Mass Screening 030212 general & internal medicine Continuous positive airway pressure Sleep study Acute Coronary Syndrome Sleep Apnea Obstructive Cognitive Behavioral Therapy Continuous Positive Airway Pressure business.industry Sleep apnea Middle Aged medicine.disease Combined Modality Therapy Peptide Fragments Clinical trial Obstructive sleep apnea C-Reactive Protein Treatment Outcome Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | International journal of cardiology. 299 |
| ISSN: | 1874-1754 |
| Popis: | Background We evaluated the effects of sleep-study guided multidisciplinary therapy (SGMT) of obstructive sleep apnoea (OSA) in patients presenting with acute coronary syndrome. Methods Eligible patients were randomized into (1) SGMT, comprised a sleep study during the index admission and continuous positive airway pressure and behavioral therapy for those with at least mild OSA or (2) standard therapy. The primary end point was the change in the plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level from baseline to the 7-month follow-up. Results A total of 159 patients completed the trial. Of the 70 patients randomized to SGMT, 21 (30%), 15 (22%) and 27 (39%) were diagnosed with mild, moderate and severe OSA, respectively. Continuous positive airway pressure and a positional pillow were prescribed to 57 (91%) and 6 (9%) patients with OSA. Although plasma NT-proBNP levels were lower after 7 months compared to the baseline, the levels did not differ significantly between the SGMT and standard therapy groups at baseline (579 ± 1117 vs. 611 ± 899 pg/dL, p = .851) or at 7 months (90 ± 167 vs. 93 ± 174 pg/dL, p = .996). The changes in NT-proBNP levels from baseline to 7 months were similar with SGMT and standard therapy (−489 vs. –518 pg/dL, p = .726). Similar findings were observed for the plasma ST2 and hs-CRP levels. Conclusions OSA screening and multifaceted treatment during the sub-acute phase of acute coronary syndrome did not further reduce the levels of cardiovascular biomarkers when compared with standard therapy. Clinical Trial Registration: clinicaltrial.gov NCT02599298 |
| Databáze: | OpenAIRE |
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