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@article{1399056,
author = {Ludka, Ondřej and Štěpánová, Radka and SertandKuniyoshi, Fatima and Špinar, Jindřich and Somers, VK and Kára, Tomáš},
article_location = {Clare (Ireland)},
article_number = {DEC 1 2017},
doi = {http://dx.doi.org/10.1016/j.ijcard.2017.06.034},
keywords = {Sleep apnea; Non-ST-elevation myocardial infarction; ST-elevation myocardial infarction; Ischemic preconditioning},
language = {eng},
issn = {0167-5273},
journal = {International Journal of Cardiology},
title = {Differential likelihood of NSTEMI vs STEMI in patients with sleep apnea},
url = {http://dx.doi.org/10.1016/j.ijcard.2017.06.034},
volume = {248},
year = {2017}
}
TY - JOUR
ID - 1399056
AU - Ludka, Ondřej - Štěpánová, Radka - Sert-Kuniyoshi, Fatima - Špinar, Jindřich - Somers, VK - Kára, Tomáš
PY - 2017
TI - Differential likelihood of NSTEMI vs STEMI in patients with sleep apnea
JF - International Journal of Cardiology
VL - 248
IS - DEC 1 2017
SP - 64-68
EP - 64-68
PB - Elsevier Ireland Ltd.
SN - 01675273
KW - Sleep apnea
KW - Non-ST-elevation myocardial infarction
KW - ST-elevation myocardial infarction
KW - Ischemic preconditioning
UR - http://dx.doi.org/10.1016/j.ijcard.2017.06.034
L2 - http://dx.doi.org/10.1016/j.ijcard.2017.06.034
N2 - Background: Sleep apnea (SA) is associated with intermittent hypoxemia that may lead to ischemic preconditioning in the myocardium. This potential cardioprotective effect of SA may play a role in the development of non-ST-elevation myocardial infarction (NSTEMI) versus ST-elevation myocardial infarction (STEMI) during acute ischemia. However, there is limited evidence about the relative prevalence of NSTEMI versus STEMI in SA patients. We therefore prospectively investigated the prevalence of these two types of MI in patients with SA. Methods: We prospectively studied 782 consecutive patients admitted with the diagnosis of acute MI (both NSTEMI and STEMI). All subjects underwent sleep evaluations using a portable diagnostic device after at least 48 h post-admission, provided they were in stable condition. Six hundred and seven out of 782 patients had technically adequate sleep studies, and therefore were included in the final analysis. Results: SA was present in 65.7% (n=399) and NSTEMI in 30% (n=182) of patients. Increasing severity of SA was associated with increasing likelihood of NSTEMI, and with decreasing likelihood of STEMI (p < 0.001). Relative frequency of NSTEMI in the moderate to severe SA group (AHI >= 15 events/h) was 40.6% versus 29.9% for STEMI (p = 0.01). Conclusion: The prevalence of NSTEMI increases with increasing severity of SA. This finding may suggest a cardioprotective role of SA, which may attenuate the development of STEMI, perhaps through ischemic preconditioning. (C) 2017 Published by Elsevier Ireland Ltd.
ER -
LUDKA, Ondřej, Radka ŠTĚPÁNOVÁ, Fatima SERT-KUNIYOSHI, Jindřich ŠPINAR, VK SOMERS and Tomáš KÁRA. Differential likelihood of NSTEMI vs STEMI in patients with sleep apnea. \textit{International Journal of Cardiology}. Clare (Ireland): Elsevier Ireland Ltd., 2017, vol.~248, DEC 1 2017, p.~64-68. ISSN~0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2017.06.034.
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