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Obstructive sleep apnoea in acute coronary syndrome
Obstructive sleep apnoea (OSA) syndrome affects about 13% of the male and 7–9% of the female population. Hypoxia, oxidative stress and systemic inflammation link OSA and cardiovascular and metabolic consequences, including coronary artery disease. Current research has identified several clinical phe...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488646/ https://www.ncbi.nlm.nih.gov/pubmed/31366458 http://dx.doi.org/10.1183/16000617.0114-2018 |
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author | Randerath, Winfried Bonsignore, Maria R. Herkenrath, Simon |
author_facet | Randerath, Winfried Bonsignore, Maria R. Herkenrath, Simon |
author_sort | Randerath, Winfried |
collection | PubMed |
description | Obstructive sleep apnoea (OSA) syndrome affects about 13% of the male and 7–9% of the female population. Hypoxia, oxidative stress and systemic inflammation link OSA and cardiovascular and metabolic consequences, including coronary artery disease. Current research has identified several clinical phenotypes, and the combination of breathing disturbances during sleep, systemic effects and end-organ damage might help to develop personalised therapeutic approaches. It is unclear whether OSA is a risk factor for acute coronary syndrome (ACS) and might affect its outcome. On the one hand, OSA in patients with ACS may worsen prognosis; on the other hand, OSA-related hypoxaemia could favour the development of coronary collaterals, thereby exerting a protective effect. It is unknown whether positive airway pressure treatment may influence adverse events and consequences of ACS. In non-sleepy patients with OSA and stable coronary artery disease, randomised controlled trials failed to show that continuous positive airway pressure (CPAP) treatment protected against cardiovascular events. Conversely, uncontrolled studies suggested positive effects of CPAP treatment in such patients. Fewer data are available in subjects with ACS and OSA, and results of randomised controlled studies on the effects of CPAP are expected shortly. Meanwhile, the search for reliable markers of risk continues. Recent studies suggest that daytime sleepiness may indicate a more severe OSA phenotype with regard to cardiovascular risk. Finally, some studies suggest sex-related differences. The picture is still incomplete, and the potential role of OSA in patients with ACS awaits confirmation, as well as clear definition of subgroups with different degrees of risk. |
format | Online Article Text |
id | pubmed-9488646 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-94886462022-11-14 Obstructive sleep apnoea in acute coronary syndrome Randerath, Winfried Bonsignore, Maria R. Herkenrath, Simon Eur Respir Rev Series Obstructive sleep apnoea (OSA) syndrome affects about 13% of the male and 7–9% of the female population. Hypoxia, oxidative stress and systemic inflammation link OSA and cardiovascular and metabolic consequences, including coronary artery disease. Current research has identified several clinical phenotypes, and the combination of breathing disturbances during sleep, systemic effects and end-organ damage might help to develop personalised therapeutic approaches. It is unclear whether OSA is a risk factor for acute coronary syndrome (ACS) and might affect its outcome. On the one hand, OSA in patients with ACS may worsen prognosis; on the other hand, OSA-related hypoxaemia could favour the development of coronary collaterals, thereby exerting a protective effect. It is unknown whether positive airway pressure treatment may influence adverse events and consequences of ACS. In non-sleepy patients with OSA and stable coronary artery disease, randomised controlled trials failed to show that continuous positive airway pressure (CPAP) treatment protected against cardiovascular events. Conversely, uncontrolled studies suggested positive effects of CPAP treatment in such patients. Fewer data are available in subjects with ACS and OSA, and results of randomised controlled studies on the effects of CPAP are expected shortly. Meanwhile, the search for reliable markers of risk continues. Recent studies suggest that daytime sleepiness may indicate a more severe OSA phenotype with regard to cardiovascular risk. Finally, some studies suggest sex-related differences. The picture is still incomplete, and the potential role of OSA in patients with ACS awaits confirmation, as well as clear definition of subgroups with different degrees of risk. European Respiratory Society 2019-07-31 /pmc/articles/PMC9488646/ /pubmed/31366458 http://dx.doi.org/10.1183/16000617.0114-2018 Text en Copyright ©ERS 2019. https://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. |
spellingShingle | Series Randerath, Winfried Bonsignore, Maria R. Herkenrath, Simon Obstructive sleep apnoea in acute coronary syndrome |
title | Obstructive sleep apnoea in acute coronary syndrome |
title_full | Obstructive sleep apnoea in acute coronary syndrome |
title_fullStr | Obstructive sleep apnoea in acute coronary syndrome |
title_full_unstemmed | Obstructive sleep apnoea in acute coronary syndrome |
title_short | Obstructive sleep apnoea in acute coronary syndrome |
title_sort | obstructive sleep apnoea in acute coronary syndrome |
topic | Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488646/ https://www.ncbi.nlm.nih.gov/pubmed/31366458 http://dx.doi.org/10.1183/16000617.0114-2018 |
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