Sleep study-guided multidisciplinary therapy (SGMT) for patients with acute coronary syndrome: Trial rationale and design

Autor: Pipin Kojodjojo, Chris Frampton, Maria Victoria Jane Macalalag Parot, Esther Hui-Ting Koh, Chi-Hang Lee, Arthur Mark Richards, Siew Pang Chan, Tun-Oo Han, Ai-Ping Chua, Eugene Siang-Joo Tan, Chieh-Yang Koo, Munirah Binte Abd Gani, Jenny P.C. Chong, William Kristanto
Rok vydání: 2018
Předmět:
Male
Acute coronary syndrome
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Trial Designs
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
0302 clinical medicine
Clinical Protocols
Randomized controlled trial
Behavior Therapy
Risk Factors
Multidisciplinary approach
law
Internal medicine
Natriuretic Peptide
Brain
medicine
Clinical endpoint
Humans
030212 general & internal medicine
Sleep study
Continuous positive airway pressure
Acute Coronary Syndrome
Patient Care Team
Singapore
Sleep Apnea
Obstructive
Continuous Positive Airway Pressure
business.industry
General Medicine
Middle Aged
medicine.disease
Combined Modality Therapy
Interleukin-1 Receptor-Like 1 Protein
Peptide Fragments
Obstructive sleep apnea
Treatment Outcome
Research Design
Biomarker (medicine)
Female
Sleep
Cardiology and Cardiovascular Medicine
business
Biomarkers
Zdroj: Clinical Cardiology. 41:721-728
ISSN: 0160-9289
Popis: Obstructive sleep apnea (OSA) is an emerging risk marker for acute coronary syndrome (ACS). This randomized trial aims to determine the effects of sleep study-guided multidisciplinary therapy (SGMT) comprising overnight sleep study, continuous positive airway pressure, and behavioral therapy for OSA during the subacute phase of ACS. We hypothesize that SGMT will reduce (1) the plasma levels of N-terminal pro brain natriuretic peptide and suppression of tumorigenicity 2; (2) the estimated 10-year risk of cardiovascular mortality as measured by the European Systematic Coronary Risk Evaluation (SCORE) algorithm; and (3) the cardiovascular event rate during a 3-year follow-up, compared with standard therapy. In the SGMT trial, 180 patients presenting with ACS will be randomly assigned to SGMT (n = 90) and standard therapy (n = 90) groups. Both groups will receive guideline-mandated treatment for ACS. Those assigned to SGMT will additionally undergo a sleep study and, if OSA is diagnosed, attend a multidisciplinary OSA clinic where they will receive personalized treatment including continuous positive airway pressure and behavioral/lifestyle counseling. The primary endpoint is the plasma N-terminal pro brain natriuretic peptide concentration at 7-month follow-up. This report presents the baseline characteristics of 117 patients (SGMT group: n =54; standard therapy group: n =63) who had been enrolled into the study as of August 31, 2017. The results of this trial will help us to understand whether active OSA diagnosis and treatment will improve the physiologic and clinical cardiovascular outcomes of this group of patients.
Databáze: OpenAIRE
Externí odkaz: