Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(6), 663–673. https://doi.org/10.1002/clc.24020 Dr. Bin Wang et al.
Points
- This prospective cohort study investigated the association between obstructive sleep apnea (OSA) and cardiovascular consequences in acute coronary syndrome (ACS) patients with metabolic syndrome (MetS).
- Among the 1927 ACS patients enrolled, 77.1% had MetS, and 52.6% had OSA, as determined by portable sleep breathing monitoring.
- Over a follow-up period of 2.9 years, there was no significant difference in the cumulative incidence of major adverse cardiovascular and cerebrovascular events (MACCE) between OSA and non-OSA groups in patients with MetS or without MetS.
- However, when analyzing the data by gender, female patients with both MetS and OSA had a significantly higher risk of MACCE than those without OSA. At the same time, there was no significant difference in MACCE risk among male patients with MetS and OSA.
- These findings highlight the importance of considering OSA as a potential risk factor for cardiovascular consequences in hospitalized ACS patients, particularly in women with MetS, and suggest the need for targeted interventions to manage this heightened risk.
Summary
This prospective cohort study aimed to examine the association between obstructive sleep apnea (OSA) and cardiovascular consequences in patients with acute coronary syndrome (ACS) and metabolic syndrome (MetS). The study included 1927 ACS patients, of whom 1486 (77.1%) had MetS and 1014 (52.6%) had OSA. Portable sleep breathing monitoring was conducted to define OSA as an apnea-hypopnea index (AHI) of 15 events/h or higher.
During a follow-up period of 2.9 years, the cumulative incidence of major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure, was assessed. In patients with MetS, the cumulative incidence of MACCE was 21.9% in the OSA group compared to 17.9% in the non-OSA group (adjusted hazard ratio [HR] = 1.29, 95% confidence interval [CI]: 0.99–1.67, p = .06). Similarly, in patients without MetS, the cumulative incidence of MACCE was 24.4% in the OSA group and 17.3% in the non-OSA group (adjusted HR = 1.21, 95% CI: 0.73–2.03, p = .46).
When stratifying the results by gender, it was observed that female patients with both MetS and OSA had a significantly higher risk of MACCE compared to those without OSA (27.8% vs. 18.1%, adjusted HR = 1.70, 95% CI: 1.01–3.09, p = .04). However, there was no significant difference in the risk of MACCE between male patients with MetS and OSA compared to those without OSA (21.0% vs. 17.9%, adjusted HR = 1.19, 95% CI: 0.91–1.59, p = .21).
These findings suggest that comorbid OSA in hospitalized ACS patients with MetS is associated with an increased risk of cardiovascular consequences, particularly in women. These results underscore the importance of considering OSA as a potential risk factor and tailoring management strategies accordingly, especially for female patients with MetS who may benefit from targeted interventions to mitigate their cardiovascular risk.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24020
References Wang, B., Liu, X., Hao, W., Fan, J., Que, B., Ai, H., Wang, X., & Nie, S. (2023). Comorbid obstructive sleep apnea is associated with adverse cardiovascular outcomes in female patients with acute coronary syndrome complicating metabolic syndrome. Clinical Cardiology, 46(6), 663–673. https://doi.org/10.1002/clc.24020
