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Published on: March 27, 2018
Obstructive sleep apnea-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary
Jiayang Wang1,2, Xinxin Wang3, Wenyuan Yu1
1Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
Insights
Obstructive sleep apnea (OSA) significantly increases major adverse events, reintubation, and acute kidney injury in coronary heart disease patients after coronary artery bypass grafting surgery.
Area of Science:
- Cardiology
- Pulmonology
- Nephrology
- Surgical Outcomes
Background:
- Coronary heart disease (CHD) patients undergoing elective coronary artery bypass grafting (CABG) face risks of postoperative multi-organ dysfunction.
- Obstructive sleep apnea (OSA) is a common comorbidity that may exacerbate these risks.
Purpose of the Study:
- To investigate the impact of obstructive sleep apnea (OSA) on postoperative multi-organ function in patients with coronary heart disease (CHD) undergoing elective coronary artery bypass grafting (CABG).
Main Methods:
- A systematic literature search of electronic databases was conducted for relevant English articles.
- Included studies compared postoperative multi-organ function in CHD patients undergoing elective CABG with and without OSA.
- Exclusion criteria included duplicate publications, unpublished studies, abstracts only, and cohorts with fewer than 30 patients.
Main Results:
- Thirteen articles met the inclusion criteria.
- OSA significantly increased major adverse cardiac and cerebrovascular events (MACCEs) (OR, 1.97; P<0.0001) and new revascularization (OR, 9.47; P<0.0001).
- OSA was associated with increased reintubation (OR, 3.43; P=0.009), tracheostomy (OR, 4.72; P=0.024), and acute kidney injury (AKI) (OR, 2.24; P<0.0001).
Conclusions:
- Obstructive sleep apnea (OSA) is linked to increased postoperative complications in CHD patients undergoing CABG.
- OSA may contribute to multi-organ dysfunction through elevated MACCEs, respiratory issues, and renal complications.
Background:
The aim of this study was to explore the underlying impact of obstructive sleep apnea (OSA) on postoperative parameters of multi-organ function among coronary heart disease (CHD) patients following elective coronary artery bypass grafting (CABG).
Methods:
Electronic literature databases were searched manually and automatically for relevant English articles. All of the included articles focused on a comparison of the incidence of postoperative parameters of multi-organ function in CHD patients undergoing elective CABG with and without OSA. Studies were excluded if they met any one of the following criteria: (I) duplicate publication; (II) ongoing or unpublished studies; (III) only published as abstracts or conference proceedings; and (IV) less than 30 patients in the patient cohort.
Results:
A total of 13 articles met our inclusion criteria. The current study demonstrated OSA significantly increased the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in CHD patients undergoing elective CABG compared with the controls [odds risk (OR), 1.97; 95% CI, 1.50 to 2.59, P<0.0001]. In addition, OSA was associated with an increased risk of new revascularization in CHD patients undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, P<0.0001). Moreover, reintubation and tracheostomy in the OSA group was increased 243% (OR, 3.43; 95% CI, 1.35 to 8.71; P=0.009) and 372% (OR, 4.72; 95% CI, 1.23 to 18.13; P=0.024), respectively, compared with the control group. Besides, we also confirmed OSA significantly increased the acute kidney injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P<0.0001).
Conclusions:
OSA may contribute to postoperative multi-organ dysfunction among CHD patients undergoing elective CABG by increasing the incidence of MACCEs, especially new revascularization, as well as respiratory, and renal complications.
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