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Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea
BACKGROUND: In patients with acute myocardial infarction (MI), cardioprotective effects of obstructive sleep apnea are postulated on account of hypoxemic preconditioning. The aim of this single‐center substudy was to investigate a potential association between obstructive sleep apnea and the presenc...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475663/ https://www.ncbi.nlm.nih.gov/pubmed/34325518 http://dx.doi.org/10.1161/JAHA.120.020340 |
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author | Summerer, Verena Arzt, Michael Fox, Henrik Oldenburg, Olaf Zeman, Florian Debl, Kurt Buchner, Stefan Stadler, Stefan |
author_facet | Summerer, Verena Arzt, Michael Fox, Henrik Oldenburg, Olaf Zeman, Florian Debl, Kurt Buchner, Stefan Stadler, Stefan |
author_sort | Summerer, Verena |
collection | PubMed |
description | BACKGROUND: In patients with acute myocardial infarction (MI), cardioprotective effects of obstructive sleep apnea are postulated on account of hypoxemic preconditioning. The aim of this single‐center substudy was to investigate a potential association between obstructive sleep apnea and the presence of coronary collaterals in patients with first‐time acute MI who have been enrolled in an ongoing, multicenter clinical trial. METHODS AND RESULTS: In TEAM‐ASV I (Treatment of Sleep Apnea Early After Myocardial Infarction With Adaptive Servo‐Ventilation Trial; NCT02093377) patients with first acute MI who received a coronary angiogram within 24 hours after onset of symptoms underwent polygraphy within the first 3 days. Coronary collaterals were classified visually by assigning a Cohen‐Rentrop Score (CRS) ranging between 0 (no collaterals) and 3. Of 94 analyzed patients, 14% had significant coronary collaterals with a CRS ≥2. Apnea‐Hypopnea Index (AHI) score was significantly higher in patients with CRS ≥2 compared with those with CRS <2 (31/hour [11–54] versus 13/hour [4–27]; P=0.032). A multivariable regression model revealed a significant association between obstructive AHI and CRS ≥2 that was independent of age, sex, body mass index, and culprit lesion left anterior descending artery (odds ratio [OR], 1.06; 95% CI, 1.01–1.12; P=0.023), but no significant association between coronary collaterals and central AHI (OR, 1.02; 95% CI, 0.97–1.08; P=0.443). CONCLUSIONS: Patients with first‐time acute MI had more extensive coronary collateralization with an increased AHI or rather an increased obstructive AHI. This finding supports the hypothesis that obstructive sleep apnea exerts potential cardioprotective effects, in addition to its known deleterious effects, in patients with acute MI. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02093377. |
format | Online Article Text |
id | pubmed-8475663 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84756632021-10-01 Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea Summerer, Verena Arzt, Michael Fox, Henrik Oldenburg, Olaf Zeman, Florian Debl, Kurt Buchner, Stefan Stadler, Stefan J Am Heart Assoc Original Research BACKGROUND: In patients with acute myocardial infarction (MI), cardioprotective effects of obstructive sleep apnea are postulated on account of hypoxemic preconditioning. The aim of this single‐center substudy was to investigate a potential association between obstructive sleep apnea and the presence of coronary collaterals in patients with first‐time acute MI who have been enrolled in an ongoing, multicenter clinical trial. METHODS AND RESULTS: In TEAM‐ASV I (Treatment of Sleep Apnea Early After Myocardial Infarction With Adaptive Servo‐Ventilation Trial; NCT02093377) patients with first acute MI who received a coronary angiogram within 24 hours after onset of symptoms underwent polygraphy within the first 3 days. Coronary collaterals were classified visually by assigning a Cohen‐Rentrop Score (CRS) ranging between 0 (no collaterals) and 3. Of 94 analyzed patients, 14% had significant coronary collaterals with a CRS ≥2. Apnea‐Hypopnea Index (AHI) score was significantly higher in patients with CRS ≥2 compared with those with CRS <2 (31/hour [11–54] versus 13/hour [4–27]; P=0.032). A multivariable regression model revealed a significant association between obstructive AHI and CRS ≥2 that was independent of age, sex, body mass index, and culprit lesion left anterior descending artery (odds ratio [OR], 1.06; 95% CI, 1.01–1.12; P=0.023), but no significant association between coronary collaterals and central AHI (OR, 1.02; 95% CI, 0.97–1.08; P=0.443). CONCLUSIONS: Patients with first‐time acute MI had more extensive coronary collateralization with an increased AHI or rather an increased obstructive AHI. This finding supports the hypothesis that obstructive sleep apnea exerts potential cardioprotective effects, in addition to its known deleterious effects, in patients with acute MI. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02093377. John Wiley and Sons Inc. 2021-07-30 /pmc/articles/PMC8475663/ /pubmed/34325518 http://dx.doi.org/10.1161/JAHA.120.020340 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Summerer, Verena Arzt, Michael Fox, Henrik Oldenburg, Olaf Zeman, Florian Debl, Kurt Buchner, Stefan Stadler, Stefan Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
title | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
title_full | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
title_fullStr | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
title_full_unstemmed | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
title_short | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
title_sort | occurrence of coronary collaterals in acute myocardial infarction and sleep apnea |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475663/ https://www.ncbi.nlm.nih.gov/pubmed/34325518 http://dx.doi.org/10.1161/JAHA.120.020340 |
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