在患有阻塞性睡眠呼吸暂停的患者中,急性ST段升高心肌梗塞发作的昼夜模式
Yueying Wang1, Keremu Buayiximu1, Tianqi Zhu1
1Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
概括
阻塞性睡眠呼吸暂停 (OSA) 患者在夜间时间出现ST段升高心肌梗塞 (STEMI) 的风险更高. 在OSA患者中,这种夜间STEMI发作独立地与不良心血管事件有关.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 内部医学 内部医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与夜间的血液动力学和神经激素变化有关,可能增加冠状动脉事件的风险.
- 在OSA患者中了解ST段升高心肌梗塞 (STEMI) 发病的日间模式对于风险分层和管理至关重要.
研究的目的:
- 为了研究OSA患者STEMI发作的昼夜模式.
- 评估STEMI发病时间对OSA患者主要心血管和脑血管不良事件的影响.
主要方法:
- 预期招募397名胸痛发病时间明确的STEMI患者.
- 将患者分为非OSA (n=280) 和OSA (n=117) 组.
- 考克斯比例危险回归分析以估计STEMI发病时间和不良心血管事件之间的关联.
主要成果:
- 在33%的OSA患者中,STEMI发作发生在午夜和上午5:59之间,而在非OSA患者中,这一比例为15% (P < .01).
- 与非OSA患者相比,OSA患者在午夜至凌晨5:59之间患STEMI的相对风险高出2.717倍.
- 在中位数2.89年的随访期间,STEMI发病时间与OSA患者的主要心血管和脑血管不良事件有显著的关联.
结论:
- 患有OSA的患者在午夜和上午5:59之间表现出STEMI的峰值发病率.
- 在OSA患者中,夜间STEMI发作是心血管不良结果的独立预测因素.
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