Sleep apnea is a stronger predictor for coronary heart disease than traditional risk factors
| Autor: | Laura Rahmeier, Roberto Pacheco da Silva, Denis Martinez, Cristini Klein, Cristiane Maria Cassol, Angelo Jose Goncalves Bos, Sandro Cadaval Gonçalves, Cintia Zappe Fiori |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Apneia do Sono Doenças Cardiovasculares Polysomnography Coronary Disease Coronary Angiography Body Mass Index Angina Coronary artery disease Predictive Value of Tests Risk Factors Internal medicine medicine Ambulatory Care Odds Ratio Health Status Indicators Humans Sleep Apnea Obstructive Framingham Risk Score medicine.diagnostic_test Fatores de risco business.industry Confounding Sleep apnea Odds ratio Middle Aged medicine.disease Causality Polissonografia Otorhinolaryngology Cardiology Doença coronariana Female Neurology (clinical) business Body mass index Brazil |
| Zdroj: | Repositório Institucional PUCRS Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) instacron:PUC_RS |
| ISSN: | 1522-1709 |
| Popis: | Sleep apnea (SA) may be linked to coronary artery disease (CAD). Both conditions have similar risk factors, confounding the analyses. Investigation of the lipid profile is routine in the adult population, even without symptoms or suspected cardiac ailment. SA, however, remains underdiagnosed even in the presence of unambiguous clinical manifestations. The aim of this study was to verify the association between SA and CAD, adjusting for usual CAD risk factors. Patients who underwent diagnostic or therapeutic coronariography and portable type III polysomnography were studied. The severity of SA was determined by the apnea–hypopnea index (AHI). We measured classic CAD risk factors: fasting glucose; total, HDL, and LDL cholesterols; triglycerides; uric acid, and high-sensitivity C-reactive protein. We excluded patients older than 65 years, with body mass index higher than 40 kg/m2, with diabetes, and with history of smoking in the last year. Of 55 included patients, 28 had AHI > 14, showing an odds ratio of 8.7 for CAD. Patients without (n = 29) and with CAD (n = 26), showed AHI of, respectively, 11 ± 11 and 23 ± 14 per hour (P = 0.001). In a binary logistic regression to predict CAD, controlling for all the above risk factors, the only variables entered in the stepwise model were AHI (either as continuous or categorical variable) and uric acid. In a sample without smokers, morbidly obese, or diabetic patients, AHI is the main predictor of CAD. SA should integrate the set of risk factors routinely assessed in clinical investigation for coronary disease risk stratification. |
| Databáze: | OpenAIRE |
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