Summerer, Verena and Arzt, Michael and Fox, Henrik and Oldenburg, Olaf and Zeman, Florian and Debl, Kurt and Buchner, Stefan and Stadler, Stefan (2021) Occurrence of Coronary Collaterals in Acute Myocardial Infarction and Sleep Apnea. JOURNAL OF THE AMERICAN HEART ASSOCIATION, 10 (15): e020340. ISSN , 2047-9980
Full text not available from this repository. (Request a copy)Abstract
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: ; Unique identifier: NCT02093377.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ENDOTHELIAL GROWTH-FACTOR; APNEALINK(TM); MORTALITY; IMPACT; coronary collaterals; hypoxic preconditioning; myocardial infarction; sleep-disordered breathing |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Sep 2022 07:10 |
| Last Modified: | 06 Sep 2022 07:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46658 |
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