Related Experiment Video
Updated: Dec 21, 2025
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Sleep apnoea and cardiovascular outcomes after coronary artery bypass grafting
Chieh Yang Koo1, Aye-Thandar Aung2, Zhengfeng Chen2
1Department of Cardiology, National University Heart Centre, Singapore christopher_koo@nuhs.edu.sg.
Insights
Sleep apnoea is a significant risk factor for major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing coronary artery bypass grafting (CABG). This finding highlights the importance of screening for sleep apnoea in this patient population.
Area of Science:
- Cardiology
- Sleep Medicine
- Public Health
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Coronary artery bypass grafting (CABG) is a common surgical intervention for advanced CAD.
- The role of sleep apnoea as a risk marker for adverse outcomes following CABG is not well-established.
Purpose of the Study:
- To investigate the association between sleep apnoea and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing non-emergent CABG.
- To determine if sleep apnoea is an independent predictor of MACCE in this cohort.
Main Methods:
- Prospective cohort study conducted from November 2013 to December 2018.
- 1007 patients undergoing non-emergent CABG were recruited.
- Overnight sleep studies using a wrist-worn Watch-PAT 200 device were performed prior to CABG.
Main Results:
- Sleep apnoea was diagnosed in 50.9% of patients (n=513).
- The 2-year cumulative incidence of MACCE was 14.7% in the sleep apnoea group versus 7.8% in the non-sleep apnoea group (p=0.002).
- Sleep apnoea remained a significant independent predictor of MACCE after adjusting for multiple clinical factors (adjusted HR 1.57; 95% CI 1.09 to 2.25).
Conclusions:
- Sleep apnoea is independently associated with an increased risk of MACCE in patients undergoing CABG.
- These findings suggest that sleep apnoea should be considered a significant risk marker in patients undergoing CABG.
- Further research may explore interventions to mitigate the risks associated with sleep apnoea in this population.
Objective:
Patients with advanced coronary artery disease are referred for coronary artery bypass grafting (CABG) and it remains unknown if sleep apnoea is a risk marker. We evaluated the association between sleep apnoea and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing non-emergent CABG.
Methods:
This was a prospective cohort study conducted between November 2013 and December 2018. Patients from four public hospitals referred to a tertiary cardiac centre for non-emergent CABG were recruited for an overnight sleep study using a wrist-worn Watch-PAT 200 device prior to CABG.
Results:
Among the 1007 patients who completed the study, sleep apnoea (defined as apnoea-hypopnoea index ≥15 events per hour) was diagnosed in 513 patients (50.9%). Over a mean follow-up period of 2.1 years, 124 patients experienced the four-component MACCE (2-year cumulative incidence estimate, 11.3%). There was a total of 33 cardiac deaths (2.5%), 42 non-fatal myocardial infarctions (3.7%), 50 non-fatal strokes (4.9%) and 36 unplanned revascularisations (3.2%). The crude incidence of MACCE was higher in the sleep apnoea group than the non-sleep apnoea group (2-year estimate, 14.7% vs 7.8%; p=0.002). Sleep apnoea predicted the incidence of MACCE in unadjusted Cox regression analysis (HR 1.69; 95% CI 1.18 to 2.43), and remained statistically significant (adjusted HR 1.57; 95% CI 1.09 to 2.25), after adjustment for age, sex, body mass index, left ventricular ejection fraction, diabetes mellitus, hypertension, chronic kidney disease and excessive daytime sleepiness.
Conclusion:
Sleep apnoea is independently associated with increased MACCE in patients undergoing CABG.
Trial Registration Number:
NCT02701504.
More Related Videos
09:54A Recovery Cardiopulmonary Bypass Model Without Transfusion or Inotropic Agents in Rats
Published on: March 23, 2018
08:35Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations