Publication details

Sleep apnea prevalence in acute myocardial infarction - The Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study

Authors

LUDKA Ondřej ŠTĚPÁNOVÁ Radka VYSKOCILOVA Martina ZIKMUND GALKOVÁ Lujza MIKOLÁŠKOVÁ Monika BELEHRAD Milos KOSTALOVA Jana MIHALOVÁ Zuzana DROZDOVÁ Adéla HLÁSENSKÝ Jiří GACÍK Michal PUDILOVÁ Lucie MIKUŠOVÁ Tereza FISCHEROVÁ Blanka SERT-KUNIYOSHI Fatima SOMERS Virend K. ŠPINAR Jindřich KÁRA Tomáš

Year of publication 2014
Type Article in Periodical
Magazine / Source International Journal of Cardiology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.ijcard.2014.06.020
Field Cardiovascular diseases incl. cardiosurgery
Keywords Sleep apnea; Acute myocardial infarction; Prevalence; Day-night variation
Description Background: While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients. Methods: We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 h post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (<5 events/h), mild SA (5-15 events/h), moderate SA (15-30 events/h), and severe SA (>= 30 events/h). Results: Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI >= 5 events/h, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6 AM to 12 PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12 AM to 6 AM (all p < 0.05). Conclusion: There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6 AM and noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.

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