Prognostic Implications of Obstructive Sleep Apnea in Acute Coronary Syndrome by Obesity Status

Chest. 2023 Feb 8:S0012-3692(23)00173-3. doi: 10.1016/j.chest.2023.02.001. Online ahead of print.ABSTRACTBACKGROUND: A close relationship exists between obstructive sleep apnea (OSA) and obesity. The impact of obesity on the prognostic significance of OSA in patients with acute coronary syndrome (ACS) remains unclear.RESEARCH QUESTION: Whether the effects of OSA on subsequent cardiovascular events in ACS patients vary with obesity status?STUDY DESIGN AND METHODS: This is a prospective cohort study. Patients aged 18 to 85 years and hospitalized for ACS were consecutively enrolled and underwent portable sleep monitoring after clinical stabilization. OSA defined as an apnea-hypopnea index ≥15 events/hour. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, hospitalization for ACS, stroke, ischemia driven revascularization, or hospitalization for heart failure.RESULTS: Among 1,920 patients enrolled (84.5% male; mean [SD] age, 56.4 [10.5] years), 1,013 (52.8%) had OSA, and 718 (37.4%) were obese (BMI ≥28). During 2.9 (1.5, 3.6) years follow-up, the incidence of MACCE was significantly higher in patients with obesity than in patients without obesity (HR 1.29; 95% CI, 1.06-1.58; P=0.013). Although the prevalence of OSA was lower in patients without obesity than in those with obesity (43.9% vs. 67.5%, P<0.001), OSA independently predicted the incidence of MACCE only in patients without obesity (adjusted HR 1....
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research