Obstructive sleep apnoea in acute coronary syndrome

Area of Science:

• Cardiology
• Sleep Medicine
• Pulmonology

Background:

• Obstructive sleep apnoea (OSA) affects a significant portion of the population, with established links to cardiovascular and metabolic diseases.
• The relationship between OSA and acute coronary syndrome (ACS) is complex, with potential for both negative prognostic impact and protective effects via hypoxemia-induced collateralization.
• Current understanding of OSA's role in ACS and the efficacy of positive airway pressure (PAP) therapy remains incomplete.

Purpose of the Study:

• To investigate the potential role of OSA as a risk factor for ACS and its impact on patient outcomes.
• To evaluate the influence of continuous positive airway pressure (CPAP) treatment on adverse events in patients with ACS and OSA.
• To identify reliable risk markers and potential sex-related differences in OSA patients with cardiovascular disease.

Main Methods:

• Review of existing research on OSA, ACS, and cardiovascular risk.
• Analysis of clinical phenotypes and systemic effects associated with OSA.
• Consideration of data from randomized controlled trials and observational studies on CPAP treatment in OSA patients with coronary artery disease.

Main Results:

• Randomized trials in stable coronary artery disease patients did not demonstrate cardiovascular event protection with CPAP, though some uncontrolled studies suggested benefits.
• Data on OSA in ACS patients are limited, with ongoing randomized studies expected to provide further insights.
• Daytime sleepiness may indicate a higher cardiovascular risk phenotype in OSA patients; sex-related differences warrant further investigation.

Conclusions:

• The precise role of OSA in ACS and its impact on prognosis require further confirmation.
• The effectiveness of CPAP in ACS patients with OSA is not yet clearly established.
• Further research is needed to define subgroups at different risk levels and elucidate sex-specific differences.