Related Experiment Videos
[Association between sleep apnea syndrome and coronary artery disease]
1First Department of Internal Medicine, Asahikawa Medical College, Japan.
Insights
Patients with sleep apnea syndrome frequently have coronary artery disease (CAD), especially coronary spasm. This study investigated the link between sleep apnea and CAD, finding a significant association, particularly with vasospastic angina.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonary Medicine
Context:
- Sleep apnea syndrome is common and linked to cardiovascular disease.
- The specific incidence of coronary artery disease (CAD) with coronary spasm in sleep apnea patients is not well-established.
- Understanding this comorbidity is crucial for patient management.
Purpose:
- To determine the prevalence of coronary artery disease (CAD), including coronary spasm, in patients diagnosed with sleep apnea syndrome.
- To explore the relationship between sleep apnea severity and the presence of CAD.
- To assess the inducibility of coronary spasm in sleep apnea patients.
Summary:
- Out of 37 men with sleep apnea syndrome, 14 showed signs of CAD. Coronary angiography confirmed CAD (organic stenosis or spasm) in 8 patients.
- No significant differences in traditional risk factors or sleep apnea severity were found between patients with and without CAD.
- Intracoronary acetylcholine testing induced coronary spasm in 36.4% of patients, and 50% of those with diagnosed CAD experienced spasm.
Impact:
- Suggests a higher frequency of CAD, particularly coronary spasm, in patients with sleep apnea syndrome.
- Highlights the need for considering CAD screening in sleep apnea patients.
- Indicates a potential pathophysiologic link between sleep apnea and coronary vasospasm, warranting further investigation.
Abstract:
Patients with sleep apnea syndrome often suffer from cardiovascular disease, but the incidence of coronary artery disease (CAD) with coronary spasm in these patients is not known. In the present study, 14 of 37 men with sleep apnea syndrome diagnosed by all-night polysomnography were suspected to also have CAD, based on the results of non-invasive clinical examinations. Coronary angiography confirmed the diagnosis of CAD either organic stenosis or coronary spasm in 8 of the 14 patients. Those 8 did not differ significantly from the 21 patients without CAD, with regard to coronary risk factors or to the severity of their sleep apnea (apnea index, 4% desaturation ratio, and nadir of SaO2). Eleven patients received intracoronary injections of acetylcholine, which induced coronary spasm in 4 (36.4%) and coronary contraction in 2 (18.2%). Coronary spasm was induced in 4 of the patients with CAD (50.0%). Although the pathophysiologic link between sleep apnea syndrome and CAD is still unclear, these results suggest that patients with this syndrome frequently suffer from CAD, particularly from coronary spasm.