ANGPTL3 and Cardiovascular Outcomes in Patients With Acute Coronary Syndrome and Obstructive Sleep Apnea

Related Experiment Video

Updated: Aug 29, 2025

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD — A Safe, Cost-Effective Approach
04:53

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD — A Safe, Cost-Effective Approach

Published on: October 18, 2024

880

Qianwen Lv1,2, Xiaolu Jiao1,2, Huahui Yu1,2

  • 1Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases Beijing China.

Journal of the American Heart Association
|September 8, 2022
PubMed

Insights

Elevated angiopoietin-like protein 3 (ANGPTL3) significantly increases cardiovascular event risk in acute coronary syndrome (ACS) patients, particularly those with obstructive sleep apnea (OSA). ANGPTL3 levels aid in refining risk stratification for ACS patients with OSA.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Sleep Medicine

Background:

  • Acute coronary syndrome (ACS) poses a significant cardiovascular risk.
  • Obstructive sleep apnea (OSA) is increasingly recognized as a cardiovascular risk factor.
  • The role of angiopoietin-like protein 3 (ANGPTL3) in cardiovascular events (CVEs) post-ACS, especially in conjunction with OSA, requires further elucidation.

Purpose of the Study:

  • To investigate the impact of elevated ANGPTL3 levels on the incidence of CVEs in patients with ACS.
  • To determine if this impact differs between patients with and without OSA.
  • To assess the predictive value of ANGPTL3 in cardiovascular risk stratification for ACS patients, considering OSA status.

Main Methods:

  • Prospective cohort study including 1174 patients with ACS who underwent percutaneous coronary intervention.
  • Patients were categorized based on OSA status (apnea-hypopnea index ≥15 events/h) and ANGPTL3 plasma levels.
  • Cardiovascular events (CVEs) were tracked over a median follow-up of 3.1 years using Cox proportional hazards models.

Main Results:

  • Patients with ACS and OSA exhibited higher ANGPTL3 levels compared to those without OSA (P<0.001).
  • Elevated ANGPTL3 levels (29≤ANGPTL3<42 mg/dL and ANGPTL3≥42 mg/dL) were associated with increased CVE risk in the overall ACS cohort.
  • This association was significantly pronounced in patients with ACS and OSA (HRs 1.916 and 2.692, respectively), but not in those without OSA. ANGPTL3 addition improved risk model C-statistic in OSA and overall ACS groups.

Conclusions:

  • Plasma ANGPTL3 levels possess a significant predictive impact on cardiovascular risk in ACS patients.
  • This predictive value is particularly pronounced in ACS patients who also have OSA.
  • ANGPTL3 may serve as a valuable biomarker for refining risk stratification and guiding treatment strategies in ACS patients with OSA.

Keywords:
acute coronary syndromeangiopoietin‐like protein 3cardiovascular outcomeobstructive sleep apneaprediction

More Related Videos

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders05:34

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders

Published on: August 18, 2023

2.4K
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

19.9K

Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
214
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
21
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
26
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
220
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
25
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
37