透皮冠状动脉干预后阻塞性睡眠呼吸暂停和心血管事件
Chi-Hang Lee1, Rishi Sethi2, Ruogu Li2
1From Department of Cardiology, National University Heart Centre, Singapore (C-H.L., G.L., C.-Y.K., P.-F.C., M.Y.C., A.M.R., H.-C.T.); Department of Cardiology, King George's Medical University, Lucknow, India (R.S., S.C., A.M., R.B.K.); Department of Cardiology, Shanghai Chest Hospital, China (R.L., X.-X.Y., W.-W.Z.); Department of Cardiology, Tan Tock Seng Hospital, Singapore (H.-H.H.); No (1) 1000-Bed Defence Services General Hospital, Mingaladon, Yangon, Myanmar (T.H.); Cardiac Medical Unit, Grantham Hospital, Hong Kong (M.-H.J.); Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (X.-F.G., Z.G., S.-L.C., J.-J.Z.); Hypertension Unit-Heart Institute (InCor), University of Sao Paulo Medical School, Brazil (S.F.F., C.H.G.U., L.F.D.); Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore (T.-H.O.); Sleep Educators, Antioch, CA (G.R.); and Saw Swee Hock School of Public Health, National University of Singapore, Singapore (B.-C.T.). mdclchr@nus.edu.sg.
阻塞性睡眠呼吸暂停 (OSA) 与支架后更多的心脏事件有关. 这项研究发现OSA独立预测经皮冠状动脉干预的患者的主要心脏和脑血管不良事件 (MACCE).
科学领域:
- 心脏病学
- 睡眠医学
- 临床研究
背景情况:
- 对于冠状动脉疾病患者的阻塞性睡眠呼吸暂停 (OSA) 预后意义的数据有限.
- 形成了一个假设,即OSA预测了经皮冠状动脉干预 (PCI) 患者的主要心脏和脑血管不良事件 (MACCE).
研究的目的:
- 在接受PCI的冠状动脉疾病患者中研究OSA的预后价值.
- 确定OSA是否是该患者群体中MACCE的独立预测因素.
主要方法:
- 一个前性的多中心注册 (睡眠和支架研究) 招募了1311名PCI后患者.
- 患者在PCI后7天内接受睡眠研究;OSA被定义为呼吸暂停- 呼吸暂停指数≥15次/小时.
- 随访时间中位数为1. 9年.
主要成果:
- 阻塞性睡眠呼吸暂停 (OSA) 在45. 3%的研究队列中存在.
- 与没有OSA患者相比,MACCE的发生率显著高 (3年估计:18. 9% vs.
- 多变量分析显示OSA是MACCE的独立预测因子 (调整后的危险比:1. 57;95% CI:1. 10-2. 24;P=0. 013).
结论:
- 阻塞性睡眠呼吸暂停 (OSA) 独立地与皮肤穿透冠状动脉干预后患者后续MACCE风险增加有关.
- 需要进一步研究治疗策略,以减轻PCI患者的OSA相关风险.
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