Respiratory Polygraphy Patterns and Risk of Recurrent Cardiovascular Events in Patients With Acute Coronary Syndrome
Zapater, Andrea (Hospital Universitari Arnau de Vilanova and Santa Maria)
Solelhac, Geoffroy (Lausanne University Hospital)
Sánchez-de-la-Torre, Alicia (Hospital Universitari Arnau de Vilanova-Santa Maria)
Gracia-Lavedan, Esther (Hospital Universitari Arnau de Vilanova-Santa Maria)
Benitez, Ivan David (Hospital Universitari Arnau de Vilanova-Santa Maria)
Torres, Gerard (Hospital Universitari Arnau de Vilanova-Santa Maria)
De Batlle, Jordi (Hospital Universitari Arnau de Vilanova-Santa Maria)
Haba-Rubio, José (Lausanne University Hospital)
Berger, Mathieu (Lausanne University Hospital)
Abad Capa, Jorge (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Duran-Cantolla, Joaquín (Arabako Unibertsitate Ospitalea (Vitoria, País Basc))
Urrutia, Amaia (Hospital Universitario de Cruces (Barakaldo, País Basc))
Mediano, Olga (Hospital Universitario de Guadalajara)
Masdeu, María José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ordax-Carbajo, Estrella (Hospital Universitario de Burgos)
Masa, Juan Fernando (Hospital San Pedro de Alcántara)
De la Peña, Mónica (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Mayos, Mercè (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Coloma, Ramon (Complejo Hospitalario Universitario de Albacete)
Montserrat, Josep María (Hospital Clínic i Provincial de Barcelona)
Chiner, Eusebi (Hospital Universitari Sant Joan d'Alacant)
Mínguez, Olga (Hospital Universitari Arnau de Vilanova-Santa Maria)
Pascual, Lydia (Hospital Universitari Arnau de Vilanova-Santa Maria)
Cortijo, Anunciación (Hospital Universitari Arnau de Vilanova-Santa Maria)
Martínez López, Dolores (Hospital Universitari Arnau de Vilanova-Santa Maria)
Dalmases, Mireia (Hospital Universitari Arnau de Vilanova-Santa Maria)
Lee, Chi-Hang (National University of Singapore)
McEvoy, R. Doug (Flinders University)
Barbé, Ferran (University of Lausanne)
Heinzer, Raphael (University of Lausanne)
Sánchez-de-la-Torre, Manuel (Hospital Universitari Arnau de Vilanova-Santa Maria)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Obstructive sleep apnea (OSA) severity is based on the apnea-hypopnea index (AHI). The AHI is a simplistic measure that is inadequate for capturing disease severity and its consequences in cardiovascular diseases (CVDs). Deleterious effects of OSA have been suggested to influence the prognosis of specific endotypes of patients with acute coronary syndrome (ACS). We aim to identify respiratory polygraphy (RP) patterns that contribute to identifying the risk of recurrent cardiovascular events in patients with ACS. Post hoc analysis of the ISAACC study, including 723 patients admitted for a first ACS (NCT01335087) in which RP was performed. To identify specific RP patterns, a principal component analysis (PCA) was performed using six RP parameters: AHI, oxygen desaturation index, mean and minimum oxygen saturation (SaO), average duration of events and percentage of time with SaO < 90%. An independent HypnoLaus population-based cohort was used to validate the RP components. From the ISAACC study, PCA showed that two RP components accounted for 70% of the variance in the RP data. These components were validated in the HypnoLaus cohort, with two similar RP components that explained 71. 3% of the variance in the RP data. The first component (component 1) was mainly characterized by low mean SaO and obstructive respiratory events with severe desaturation, and the second component (component 2) was characterized by high mean SaO and long-duration obstructive respiratory events without severe desaturation. In the ISAACC cohort, component 2 was associated with an increased risk of recurrent cardiovascular events in the third tertile with an adjusted hazard ratio (95% CI) of 2. 44 (1. 07 to 5. 56; p -value = 0. 03) compared to first tertile. For component 1, no significant association was found for the risk of recurrent cardiovascular events. A RP component, mainly characterized by intermittent hypoxemia, is associated with a high risk of recurrent cardiovascular events in patients without previous CVD who have suffered a first ACS.
Ayudas:	Instituto de Salud Carlos III PI18/00449 Instituto de Salud Carlos III PI19/00907
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Acute coronary syndrome ; Cardiovascular disease ; Obstructive sleep apnea ; Precision medicine ; Respiratory polygraphy
Publicado en:	Frontiers in Medicine, Vol. 9 (june 2022) , ISSN 2296-858X

DOI: 10.3389/fmed.2022.870906
PMID: 35833104

10 p, 1.1 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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