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Akut koroner sendrom hastalarında, obstrüktif uyku apne sendromunun değerlendirilmesi

Year 2020, Volume: 27 Issue: 1, 39 - 44, 01.03.2020
https://doi.org/10.17343/sdutfd.464307

Abstract

Amaç: Obstrüktif uyku apne sendromu (OSAS)
kardiyovasküler hastalıklar ile yakın ilişki içindedir. Basitleştirilmiş OSAS
diyagnostik metodolojilerinin değerlendirilmesi halen yenidir ve kardiyoloji
alanında derinlemesine araştırılmamıştır. Bu çalışmada, ülkemizdeki akut
koroner sendrom (AKS) hastalarında OSAS ilişkisini ve koroner arter hastalığı
ciddiyeti ilişkisini, SYNTAX skoru, Berlin Uyku Anketi (BUA) ve Epworth
Uykululuk Ölçeği (EUÖ) kullanarak değerlendirmeyi amaçladık.



Hastalar ve
Yöntemler
: Akut koroner
sendrom ile başvuran ve koroner anjiyografi yapılan 160 hasta çalışmaya dahil
edildi [n=80 ST segment yükselmeli myokard infaktüsü (STEMİ) ve n=80 ST segment
yükselmesiz myokard infaktüsü (NSTEMİ)]. Hastaların SYNTAX skorları hesaplandı.
Hastalara taburculuk öncesi  (BUA) ve
(EUÖ) uygulandı. Ölçekler iki grup arasında ve hastaların SYNTAX skoru ile
kıyaslandı.



Bulgular: NSTEMİ hastalarında BUA ve EUÖ’ye göre
yüksek riskli hasta oranı STEMİ grubuna göre istatiksel olarak anlamlı
saptanmıştır (p<0.001, p=0.023). BUA ve EUÖ’de saptanan toplam puan
miktarları NSTEMİ hastalarında STEMİ grubuna göre istatiksel olarak anlamlı
saptanmıştır (p<0.001). Pearson korelasyon analizinde SYNTAX skoru ile
BUA’da saptanan toplam puan arasında ve SYNTAX skoru ile EUÖ arasında anlamlı
pozitif korelasyon saptanmıştır (r = 0.865, p <0.001 ve r = 0.761, p
<0.001)



Sonuç: Bu çalışmada, OSAS ve AKS arasındaki
ilişki değerlendirilmiştir. BUA ve EUÖ ölçeği sonuçları literatüre göre yüksek
saptanmıştır ve SYNTAX skoru ve OSAS riski arasında pozitif korelasyon
saptanmıştır.

References

  • 1. Speir WA, Jr., Chaudhary BA. Cardiovascular consequences of sleep apnea. Journal of the Medical Association of Georgia. 1982;71(10):721-2.
  • 2. Lyons OD, Bradley TD. Heart Failure and Sleep Apnea. The Canadian journal of cardiology. 2015;31(7):898-908.
  • 3. Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J, Jr., et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28(4):499-521.
  • 4. de Oliveira ACT, Martinez D, Vasconcelos LFT, Cadaval Goncalves S, do Carmo Lenz M, Costa Fuchs S, et al. Diagnosis of obstructive sleep apnea syndrome and its outcomes with home portable monitoring. Chest. 2009;135(2):330-6.
  • 5. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Annals of internal medicine. 1999;131(7):485-91.
  • 6. Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep & breathing = Schlaf & Atmung. 2008;12(2):161-8.
  • 7. Jia S, Zhou YJ, Yu Y, Wu SJ, Sun Y, Wang ZJ, et al. Obstructive sleep apnea is associated with severity and long-term prognosis of acute coronary syndrome. Journal of geriatric cardiology : JGC. 2018;15(2):146-52.
  • 8. Szymanski FM, Filipiak KJ, Hrynkiewicz-Szymanska A, Karpinski G, Opolski G. Clinical characteristics of patients with acute coronary syndrome at high clinical suspicion for obstructive sleep apnea syndrome. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese. 2013;54(5):348-54.
  • 9. Manfrini O, Pizzi C, Trere D, Fontana F, Bugiardini R. Parasympathetic failure and risk of subsequent coronary events in unstable angina and non-ST-segment elevation myocardial infarction. European heart journal. 2003;24(17):1560-6.
  • 10. Dematteis M, Julien C, Guillermet C, Sturm N, Lantuejoul S, Mallaret M, et al. Intermittent hypoxia induces early functional cardiovascular remodeling in mice. American journal of respiratory and critical care medicine. 2008;177(2):227-35.
  • 11. Prabhakar NR, Kumar GK, Nanduri J. Intermittent hypoxia-mediated plasticity of acute O2 sensing requires altered red-ox regulation by HIF-1 and HIF-2. Annals of the New York Academy of Sciences. 2009;1177:162-8.
  • 12. Foster GE, Brugniaux JV, Pialoux V, Duggan CT, Hanly PJ, Ahmed SB, et al. Cardiovascular and cerebrovascular responses to acute hypoxia following exposure to intermittent hypoxia in healthy humans. The Journal of physiology. 2009;587(Pt 13):3287-99.
  • 13. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. The Journal of clinical investigation. 1995;96(4):1897-904.
  • 14. Veerasamy M, Bagnall A, Neely D, Allen J, Sinclair H, Kunadian V. Endothelial dysfunction and coronary artery disease: a state of the art review. Cardiology in review. 2015;23(3):119-29.
  • 15. Kato M, Roberts-Thomson P, Phillips BG, Haynes WG, Winnicki M, Accurso V, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation. 2000;102(21):2607-10.
  • 16. El Solh AA, Akinnusi ME, Baddoura FH, Mankowski CR. Endothelial cell apoptosis in obstructive sleep apnea: a link to endothelial dysfunction. American journal of respiratory and critical care medicine. 2007;175(11):1186-91.
  • 17. Kundi H. Syntax score and inflammation. Herz. 2016;41(6):535-6.
  • 18. Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation. 2005;112(17):2660-7.
  • 19. Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107(8):1129-34.
  • 20. Kokturk O, Ciftci TU, Mollarecep E, Ciftci B. Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. International heart journal. 2005;46(5):801-9.
  • 21. Prejean SP, Din M, Reyes E, Hage FG. Guidelines in review: Comparison of the 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. 2018;25(3):769-76.
  • 22. Farooq V, Serruys PW, Bourantas C, Vranckx P, Diletti R, Garcia Garcia HM, et al. Incidence and multivariable correlates of long-term mortality in patients treated with surgical or percutaneous revascularization in the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial. European heart journal. 2012;33(24):3105-13.

Evaluation of obstructive sleep apnea syndrome in patients with acute coronary syndrome

Year 2020, Volume: 27 Issue: 1, 39 - 44, 01.03.2020
https://doi.org/10.17343/sdutfd.464307

Abstract

Background:
Obstructive sleep apnea syndrome
(OSAS) is closely associated with cardiovascular diseases. Evaluation of
simplified OSAS diagnostic methodologies is still new and has not been deeply
investigated in the field of cardiology. In this study, we aimed to evaluate
the relationship between OSAS and the severity of coronary artery disease in
our patients with acute coronary syndrome (ACS), using the SYNTAX score, the
Berlin Sleep Questionnaire (BUA) and the Epworth Sleepiness Scale (EUÖ).

Patients &
Methods
:  200 patients with acute coronary syndrome who
underwent coronary angiography were enrolled in the study. SYNTAX scores of the
patients were calculated. Patients were administered BUA and EUÖ before discharge.
The scales were compared between the two groups and with SYNTAX scores of
patients.

Results: In NSTEMI patients, the rate of high-risk patients in the
BUA and ACL was statistically significant compared to the STEMI group
(p<0.001,
p=0.023). The total score of the BUA and the
total score in the EUÖ was statistically significant in NSTEMI patients
compared to the STEMI group (p<0.001).
Pearson correlation analysis revealed a significant positive correlation
between the SYNTAX score and the total score in the BUA and between the SYNTAX
score and the EUÖ (r = 0.865, p <0.001 ve r = 0.761, p <0.001)







Conclusions: In this study, the relationship between OSAS and ACS was
evaluated. The results of the BUA and EUÖ scale were higher than those of other
countries and a positive correlation was found between SYNTAX score and OSAS
risk.

References

  • 1. Speir WA, Jr., Chaudhary BA. Cardiovascular consequences of sleep apnea. Journal of the Medical Association of Georgia. 1982;71(10):721-2.
  • 2. Lyons OD, Bradley TD. Heart Failure and Sleep Apnea. The Canadian journal of cardiology. 2015;31(7):898-908.
  • 3. Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J, Jr., et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28(4):499-521.
  • 4. de Oliveira ACT, Martinez D, Vasconcelos LFT, Cadaval Goncalves S, do Carmo Lenz M, Costa Fuchs S, et al. Diagnosis of obstructive sleep apnea syndrome and its outcomes with home portable monitoring. Chest. 2009;135(2):330-6.
  • 5. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Annals of internal medicine. 1999;131(7):485-91.
  • 6. Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep & breathing = Schlaf & Atmung. 2008;12(2):161-8.
  • 7. Jia S, Zhou YJ, Yu Y, Wu SJ, Sun Y, Wang ZJ, et al. Obstructive sleep apnea is associated with severity and long-term prognosis of acute coronary syndrome. Journal of geriatric cardiology : JGC. 2018;15(2):146-52.
  • 8. Szymanski FM, Filipiak KJ, Hrynkiewicz-Szymanska A, Karpinski G, Opolski G. Clinical characteristics of patients with acute coronary syndrome at high clinical suspicion for obstructive sleep apnea syndrome. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese. 2013;54(5):348-54.
  • 9. Manfrini O, Pizzi C, Trere D, Fontana F, Bugiardini R. Parasympathetic failure and risk of subsequent coronary events in unstable angina and non-ST-segment elevation myocardial infarction. European heart journal. 2003;24(17):1560-6.
  • 10. Dematteis M, Julien C, Guillermet C, Sturm N, Lantuejoul S, Mallaret M, et al. Intermittent hypoxia induces early functional cardiovascular remodeling in mice. American journal of respiratory and critical care medicine. 2008;177(2):227-35.
  • 11. Prabhakar NR, Kumar GK, Nanduri J. Intermittent hypoxia-mediated plasticity of acute O2 sensing requires altered red-ox regulation by HIF-1 and HIF-2. Annals of the New York Academy of Sciences. 2009;1177:162-8.
  • 12. Foster GE, Brugniaux JV, Pialoux V, Duggan CT, Hanly PJ, Ahmed SB, et al. Cardiovascular and cerebrovascular responses to acute hypoxia following exposure to intermittent hypoxia in healthy humans. The Journal of physiology. 2009;587(Pt 13):3287-99.
  • 13. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. The Journal of clinical investigation. 1995;96(4):1897-904.
  • 14. Veerasamy M, Bagnall A, Neely D, Allen J, Sinclair H, Kunadian V. Endothelial dysfunction and coronary artery disease: a state of the art review. Cardiology in review. 2015;23(3):119-29.
  • 15. Kato M, Roberts-Thomson P, Phillips BG, Haynes WG, Winnicki M, Accurso V, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation. 2000;102(21):2607-10.
  • 16. El Solh AA, Akinnusi ME, Baddoura FH, Mankowski CR. Endothelial cell apoptosis in obstructive sleep apnea: a link to endothelial dysfunction. American journal of respiratory and critical care medicine. 2007;175(11):1186-91.
  • 17. Kundi H. Syntax score and inflammation. Herz. 2016;41(6):535-6.
  • 18. Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation. 2005;112(17):2660-7.
  • 19. Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107(8):1129-34.
  • 20. Kokturk O, Ciftci TU, Mollarecep E, Ciftci B. Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. International heart journal. 2005;46(5):801-9.
  • 21. Prejean SP, Din M, Reyes E, Hage FG. Guidelines in review: Comparison of the 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. 2018;25(3):769-76.
  • 22. Farooq V, Serruys PW, Bourantas C, Vranckx P, Diletti R, Garcia Garcia HM, et al. Incidence and multivariable correlates of long-term mortality in patients treated with surgical or percutaneous revascularization in the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial. European heart journal. 2012;33(24):3105-13.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Serdar Kuyumcu

Fatih Öksüz This is me

Publication Date March 1, 2020
Submission Date September 26, 2018
Acceptance Date October 19, 2018
Published in Issue Year 2020 Volume: 27 Issue: 1

Cite

Vancouver Kuyumcu S, Öksüz F. Akut koroner sendrom hastalarında, obstrüktif uyku apne sendromunun değerlendirilmesi. Med J SDU. 2020;27(1):39-44.

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