Obstructive sleep apnoea and coronary revascularisation outcomes.

Area of Science:

• Cardiology
• Sleep Medicine
• Cardiovascular Surgery

Background:

• Obstructive sleep apnoea (OSA) is a prevalent chronic sleep disorder often overlooked in cardiovascular practice.
• OSA is increasingly recognized as a cardiovascular risk factor due to its association with adverse cardiac outcomes.
• OSA contributes to cardiovascular disease through mechanisms like oxidative stress and endothelial dysfunction.

Purpose of the Study:

• To review the correlation between obstructive sleep apnoea and outcomes following coronary revascularisation.
• To highlight the prevalence and independent predictive value of OSA in patients undergoing cardiac procedures.

Main Methods:

• Literature review focusing on the relationship between OSA and coronary revascularisation outcomes.
• Analysis of existing data on OSA prevalence in patients undergoing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).

Main Results:

• Obstructive sleep apnoea is present in approximately 50% of patients undergoing coronary revascularisation.
• Untreated OSA is an independent predictor of adverse events after both PCI and CABG.
• Early randomized trials on OSA treatment showed limited cardiovascular benefits, potentially due to poor adherence.

Conclusions:

• While systematic OSA screening is not currently indicated for all patients undergoing revascularisation, targeted screening is recommended for those with excessive daytime sleepiness or uncontrolled hypertension.
• Treatment of OSA offers proven benefits in blood pressure control and quality of life.
• Further research may clarify the role of OSA treatment in improving cardiovascular outcomes post-revascularisation.