The Relationship Between Obstructive Sleep Apnea Hypopnea Syndrome and Inflammatory Markers and Quality of Life in Subjects With Acute Coronary Syndrome.

BACKGROUND

The objective of this work was to examine the relationship between obstructive sleep apnea (OSA) and inflammatory markers and quality of life in patients with acute coronary syndrome, especially undergoing percutaneous coronary intervention.

METHODS

One hundred eighteen subjects were admitted with acute coronary syndrome over 1 y who had symptoms of OSA and positive polysomnography on admission. Of these subjects, 53 underwent primary percutaneous coronary intervention during their admission, and 65 had medical management. We then compared inflammatory markers by OSA status. We also assessed cardiac symptoms using the Seattle Angina Questionnaire and sleep symptoms using the Epworth Sleepiness Scale.

RESULTS

Subjects in the percutaneous coronary intervention group had a higher oxygen desaturation index (ODI) (P = .02) and apnea-hypopnea index (AHI) (P = .048) compared with those in the medical management group. In percutaneous coronary intervention subjects, the moderate-severe OSA group (AHI ≥ 15/h) had a higher hematocrit (P = .047), homocysteine (P = .01), and high-sensitivity C-reactive protein (P = .045) compared with those with no or mild OSA (AHI < 15/h). There was a significant correlation between high-sensitivity C-reactive protein and both AHI (r = 0.46, P = .001) and ODI (r = 0.47, P < .001). Those with moderate-severe OSA had higher Epworth Sleepiness Scale (P = .002), greater physical limitation (P = .01), and lower treatment satisfaction and disease perception (P = .007), as judged by subscales of the Seattle Angina Questionnaire, compared with those with no or mild OSA. Finally, subjects undergoing percutaneous coronary intervention with lower AHI (r = 0.48, P < .001) and ODI (r = 0.49, P < .001) reported higher treatment satisfaction.

CONCLUSIONS

Subjects with acute coronary syndrome undergoing percutaneous coronary intervention who had moderate-severe OSA showed higher levels of inflammatory mediators and lower treatment satisfaction and disease perception. These factors may increase the risk of adverse sequelae by increasing the systemic inflammatory response.