Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea
Background In patients with acute myocardial infarction (MI), cardioprotective effects of obstructive sleep apnea are postulated on account of hypoxemic preconditioning. The aim of this single‐center substudy was to investigate a potential association between obstructive sleep apnea and the presence...
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| Format: | Article |
| Language: | English |
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Wiley
2021-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.020340 |
| _version_ | 1811336100871929856 |
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| author | Verena Summerer Michael Arzt Henrik Fox Olaf Oldenburg Florian Zeman Kurt Debl Stefan Buchner Stefan Stadler |
| author_facet | Verena Summerer Michael Arzt Henrik Fox Olaf Oldenburg Florian Zeman Kurt Debl Stefan Buchner Stefan Stadler |
| author_sort | Verena Summerer |
| collection | DOAJ |
| description | Background In patients with acute myocardial infarction (MI), cardioprotective effects of obstructive sleep apnea are postulated on account of hypoxemic preconditioning. The aim of this single‐center substudy was to investigate a potential association between obstructive sleep apnea and the presence of coronary collaterals in patients with first‐time acute MI who have been enrolled in an ongoing, multicenter clinical trial. Methods and Results In TEAM‐ASV I (Treatment of Sleep Apnea Early After Myocardial Infarction With Adaptive Servo‐Ventilation Trial; NCT02093377) patients with first acute MI who received a coronary angiogram within 24 hours after onset of symptoms underwent polygraphy within the first 3 days. Coronary collaterals were classified visually by assigning a Cohen‐Rentrop Score (CRS) ranging between 0 (no collaterals) and 3. Of 94 analyzed patients, 14% had significant coronary collaterals with a CRS ≥2. Apnea‐Hypopnea Index (AHI) score was significantly higher in patients with CRS ≥2 compared with those with CRS <2 (31/hour [11–54] versus 13/hour [4–27]; P=0.032). A multivariable regression model revealed a significant association between obstructive AHI and CRS ≥2 that was independent of age, sex, body mass index, and culprit lesion left anterior descending artery (odds ratio [OR], 1.06; 95% CI, 1.01–1.12; P=0.023), but no significant association between coronary collaterals and central AHI (OR, 1.02; 95% CI, 0.97–1.08; P=0.443). Conclusions Patients with first‐time acute MI had more extensive coronary collateralization with an increased AHI or rather an increased obstructive AHI. This finding supports the hypothesis that obstructive sleep apnea exerts potential cardioprotective effects, in addition to its known deleterious effects, in patients with acute MI. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02093377. |
| first_indexed | 2024-04-13T17:34:36Z |
| format | Article |
| id | doaj.art-c59adecb6b10405ca1714c731c17fdab |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:34:36Z |
| publishDate | 2021-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c59adecb6b10405ca1714c731c17fdab2022-12-22T02:37:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-08-01101510.1161/JAHA.120.020340Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep ApneaVerena Summerer0Michael Arzt1Henrik Fox2Olaf Oldenburg3Florian Zeman4Kurt Debl5Stefan Buchner6Stefan Stadler7Department of Internal Medicine II University Hospital Regensburg Regensburg GermanyDepartment of Internal Medicine II University Hospital Regensburg Regensburg GermanyClinic for General and Interventional Cardiology/Angiology Heart and Diabetes Center NRW Ruhr University Bochum Bad Oeynhausen GermanyClinic for General and Interventional Cardiology/Angiology Heart and Diabetes Center NRW Ruhr University Bochum Bad Oeynhausen GermanyCenter for Clinical Studies, Biostatistics University Hospital Regensburg Regensburg GermanyDepartment of Internal Medicine II University Hospital Regensburg Regensburg GermanyDepartment of Internal Medicine II University Hospital Regensburg Regensburg GermanyDepartment of Internal Medicine II University Hospital Regensburg Regensburg GermanyBackground In patients with acute myocardial infarction (MI), cardioprotective effects of obstructive sleep apnea are postulated on account of hypoxemic preconditioning. The aim of this single‐center substudy was to investigate a potential association between obstructive sleep apnea and the presence of coronary collaterals in patients with first‐time acute MI who have been enrolled in an ongoing, multicenter clinical trial. Methods and Results In TEAM‐ASV I (Treatment of Sleep Apnea Early After Myocardial Infarction With Adaptive Servo‐Ventilation Trial; NCT02093377) patients with first acute MI who received a coronary angiogram within 24 hours after onset of symptoms underwent polygraphy within the first 3 days. Coronary collaterals were classified visually by assigning a Cohen‐Rentrop Score (CRS) ranging between 0 (no collaterals) and 3. Of 94 analyzed patients, 14% had significant coronary collaterals with a CRS ≥2. Apnea‐Hypopnea Index (AHI) score was significantly higher in patients with CRS ≥2 compared with those with CRS <2 (31/hour [11–54] versus 13/hour [4–27]; P=0.032). A multivariable regression model revealed a significant association between obstructive AHI and CRS ≥2 that was independent of age, sex, body mass index, and culprit lesion left anterior descending artery (odds ratio [OR], 1.06; 95% CI, 1.01–1.12; P=0.023), but no significant association between coronary collaterals and central AHI (OR, 1.02; 95% CI, 0.97–1.08; P=0.443). Conclusions Patients with first‐time acute MI had more extensive coronary collateralization with an increased AHI or rather an increased obstructive AHI. This finding supports the hypothesis that obstructive sleep apnea exerts potential cardioprotective effects, in addition to its known deleterious effects, in patients with acute MI. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02093377.https://www.ahajournals.org/doi/10.1161/JAHA.120.020340coronary collateralshypoxic preconditioningmyocardial infarctionsleep‐disordered breathing |
| spellingShingle | Verena Summerer Michael Arzt Henrik Fox Olaf Oldenburg Florian Zeman Kurt Debl Stefan Buchner Stefan Stadler Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary collaterals hypoxic preconditioning myocardial infarction sleep‐disordered breathing |
| title | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
| title_full | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
| title_fullStr | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
| title_full_unstemmed | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
| title_short | Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea |
| title_sort | occurrence of coronary collaterals in acute myocardial infarction and sleep apnea |
| topic | coronary collaterals hypoxic preconditioning myocardial infarction sleep‐disordered breathing |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.020340 |
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