Impact of Obstructive Sleep Apnea on Platelet Function Profiles in Patients With Acute Coronary Syndrome Taking Dual Antiplatelet Therapy

ObjectiveThe prognostic significance of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS) according to diabetes mellitus (DM) status remains unclear. We aimed to elucidate the association of OSA with subsequent cardiovascular events in patients with ACS with or without DM.Research design and methodsIn this prospective cohort study, consecutive eligible patients with ACS underwent cardiorespiratory polygraphy between June 2015 and May 2017. OSA was defined as an Apnea Hypopnea Index ≥15 events/hour. The primary end point was major adverse cardiovascular and cerebrovascular events (MACCEs), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.ResultsAmong 804 patients, 248 (30.8%) had DM and 403 (50.1%) had OSA. OSA was associated with 2.5 times the risk of 1 year MACCE in patients with DM (22.3% vs 7.1% in the non-OSA group; adjusted HR (HR)=2.49, 95% CI 1.16 to 5.35, p=0.019), but not in patients without DM (8.5% vs 7.7% in the non-OSA group, adjusted HR=0.94, 95% CI 0.51 to 1.75, p=0.85). Patients with DM without OSA had a similar 1 year MACCE rate as patients without DM. The increased risk of events was predominately isolated to patients with OSA with baseline glucose or hemoglobin A1c levels above the median. Combined OSA and longer hypoxia duration (time with arterial oxygen saturation <90%>22 min) further increased the MACCE rate to 31.0% in patients with DM.ConclusionsOSA was associated with increased risk of 1 year MACCE following ACS in patients with DM, but not in non-DM patients. Further trials exploring the efficacy of OSA treatment in high-risk patients with ACS and DM are warranted.

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High risk for obstructive sleep apnea in patients with acute coronary syndrome: initial experience from a coronary unit

Critical Care ◽

10.1186/cc7837 ◽

2009 ◽

Vol 13 (S3) ◽

Author(s):

LF Drager ◽

AP Balsanalli ◽

EL Busch ◽

M Knobel ◽

RCR Macedo ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Acute Coronary Syndrome ◽

Sleep Apnea ◽

High Risk ◽

Initial Experience ◽

Coronary Syndrome ◽

Obstructive Sleep

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Cell Death Biomarkers and Obstructive Sleep Apnea: Implications in the Acute Coronary Syndrome

SLEEP ◽

10.1093/sleep/zsx049 ◽

2017 ◽

Vol 40 (5) ◽

Cited By ~ 3

Author(s):

Josep Miquel Bauça ◽

Aina Yañez ◽

Laura Fueyo ◽

Mónica de la Peña ◽

Javier Pierola ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cell Death ◽

Acute Coronary Syndrome ◽

Sleep Apnea ◽

Coronary Syndrome ◽

Obstructive Sleep

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Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry

Arquivos Brasileiros de Cardiologia ◽

10.5935/abc.20160195 ◽

2016 ◽

Author(s):

Flavia C Maia ◽

Alessandra C. Goulart ◽

Luciano F. Drager ◽

Henrique L. Staniak ◽

Itamar de Souza Santos ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Acute Coronary Syndrome ◽

Sleep Apnea ◽

High Risk ◽

Coronary Syndrome ◽

Obstructive Sleep

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Integrative Analysis of Key Candidate Genes and Signaling Pathways in Acute Coronary Syndrome Related to Obstructive Sleep Apnea by bioinformatics

10.21203/rs.3.rs-151549/v1 ◽

2021 ◽

Author(s):

Yanxi Shi ◽

Zhengye Jiang ◽

Liqin Jiang

Keyword(s):

Obstructive Sleep Apnea ◽

Acute Coronary Syndrome ◽

Sleep Apnea ◽

Molecular Marker ◽

Candidate Genes ◽

Gene Expression Omnibus ◽

Signaling Cascades ◽

Ppi Network ◽

Coronary Syndrome ◽

Obstructive Sleep

Abstract Background: Although obstructive sleep apnea (OSA) has been clinically reported to be associated with acute coronary syndrome (ACS), the pathogenesis between the two is unclear. Herein, we analyzed and screened out the prospective molecular marker.Methods: To explore the candidate genes, as well as signaling cascades involved in ACS related to OSA, we extracted the integrated differentially expressed genes (DEGs) from the intersection of genes from the Gene Expression Omnibus (GEO) cohorts and text mining, followed by enrichment of the matching cell signal cascade through DAVID analysis. Moreover, the MCODE of Cytoscape software was employed to uncover the protein-protein interaction (PPI) network and the matching hub gene.Results: A total of 17 and 43 integrated human DEGs in unstable Angina (UA) and myocardial infarction (MI) group associated with OSAs were uncovered, respectively, that met the criteria of |log2 fold change (FC)| ≥1, adjusted P <0.01. After PPI network construction, the top five hub genes associated with UA were extracted, including APP, MAPK3, MMP9, CD40 and CD40LG, whereas those associated with MI were PPARG, MAPK1, MMP9, AGT, and TGFB1.Conclusions: The establishment of the above-mentioned candidate key genes, as well as the enriched signaling cascades provides promising molecular marker for OSA-related ACS, which may help the diagnosis and treatment of ACS patients in the future.

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