Clinical Implications of Sleep Disordered Breathing in Acute Myocardial InfarctionReportar como inadecuado




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Background

Sleep disordered breathing SDB, characterized by nightly intermittent hypoxia, is associated with multiple pathophysiologic alterations that may adversely affect patients with acute myocardial infarction AMI. This prospective study investigated whether the metabolic perturbations associated with SDB are present when these patients develop AMI and if they affect clinical outcomes.

Methods

We prospectively enrolled 180 AMI patients. SDB was defined as oxygen desaturation index ODI >5 events-hour based on a Watch Pat-100 sleep study. Blood samples were obtained for high-sensitivity C-reactive protein hs-CRP and markers of oxidative stress lipid peroxides PD and serum paraoxonase-1 PON-1 arylesterase activity. Echocardiography was performed to evaluate cardiac dimensions and pulmonary artery systolic pressure.

Results

SDB was present in 116 64% patients. Hs-CRP levels, PD and PON-1 were similar in patients with and without SDB. Echocardiography revealed higher left atrial dimension 4.1±0.5 vs 3.8±0.5 cm; P = 0.003 and a significant positive correlation between ODI and pulmonary artery systolic pressure r = 0.41, P<0.0001. After a median follow up of 68 months, no significant differences were observed between the study groups with regard to clinical outcomes, including death, heart failure, myocardial infarction and unstable angina.

Conclusion

There is a high prevalence of previously undiagnosed SDB among patients with AMI. SDB in the setting of AMI is associated with higher pulmonary artery systolic pressure. SDB was not associated with adverse clinical outcomes.



Autor: Doron Aronson , Morad Nakhleh, Tawfiq Zeidan-Shwiri, Michael Mutlak, Peretz Lavie, Lena Lavie

Fuente: http://plos.srce.hr/



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