Effects of sleep apnoea syndrome on severity of coronary artery disease in patients undergoing primary percutaneous coronary intervention

Abstract

Background: Obstructive sleep apnoea (OSA) has been a recognized factor in many diseases, either alone or
combined with other risk factors. Studies have emphasized on the important pathophysiological mechanisms
that sleep apnoea and atherosclerotic cardiovascular diseases share in common.
Patients and methods: Two groups of patients were studied in prospective observational study January 2019
to July 2020 , using STOP-BANG score, first group (n: 25); were low-risk for the development of sleep
apnoea, home sleep test (HST) was not done for them and the second group (n: 25); were high risk for
development for sleep apnoea and HST was done for them. Comparison of both groups done in their general
characteristics (as: age, BMI, presence of other risk factors for CAD, smoking) and severity of CAD that was
identified during primary percutaneous coronary intervention (PCI). The high-risk group for whom we did
HST, we identified the severity of sleep apnoea by apnoea- hypopnoea index (AHI) and mean minimum
SPO22.
Results: The high-risk group had significant increased body mass index (BMI), with insignificant differences
between the two groups regarding age, gender and smoking status. Hypertension was found frequently in the
high-risk group but hyperlipidemia was more in the low risk group. Morbidity from coronary artery disease
was comparable in the two groups (both having a mean follow up ejection fraction of 52 after 6 months).
Importantly, Nearly half of high-risk patients (n: 12) had mild OSA (n: 12) and 28% had moderate OSA (n:
7) and severe OSA was found in 12% (n: 3) with a mean minimum SPO2 of 85%.
Conclusions: Raised BMI is an important predictor of presence of sleep apnoea in patients with acute
myocardial infarction.