PMID- 10903224
OWN - NLM
STAT- MEDLINE
DCOM- 20000913
LR  - 20061115
IS  - 1073-449X (Print)
IS  - 1073-449X (Linking)
VI  - 162
IP  - 1
DP  - 2000 Jul
TI  - Respiratory disturbance index: an independent predictor of mortality in coronary 
      artery disease.
PG  - 81-6
AB  - Cardiovascular mortality was prospectively investigated in consecutive coronary 
      artery disease (CAD) patients with versus without obstructive sleep apnea (OSA) 
      during a follow-up period of 5 yr. An overnight sleep/ventilatory study was 
      performed in patients requiring intensive care (n = 62, mean age 67.6 +/- 10.4 
      yr, range 44 to 86) during a stable condition (New York Heart Association [NYHA] 
      functional class I-II) 4 to 21 mo after discharge from the hospital. OSA, defined 
      as a respiratory disturbance index (RDI) of 10/h or more was found in 19 patients 
      (mean RDI 17.5 +/- 8.3). Three OSA subjects who were successfully treated with 
      continuous positive airway pressure (CPAP) during the observation period were 
      excluded from the final analysis. There was no statistically significant 
      difference (Fisher two-tailed exact test) between the OSA and non-OSA patient 
      groups in terms of number of elderly subjects (age >/= 65 yr), gender, obesity 
      (body mass index [BMI] >/= 30 kg/m(2)), smoking history, presence of 
      hypertension, diabetes mellitus, hypercholesterolemia, or history of myocardial 
      infarction at the study start. During the follow-up period, cardiovascular death 
      occurred in six of 16 OSA patients (37.5%) compared with 4 (9.3%) in the non-OSA 
      group (p = 0.018). The univariate predictors of cardiovascular mortality were RDI 
      (p = 0.007), OSA (p = 0.014), age at baseline (p = 0.028), hypertension at 
      baseline (p = 0.036), history of never-smoking (p = 0.031), and digoxin treatment 
      during the follow-up period (p = 0.013). In a Cox multiple conditional regression 
      model, RDI remained as an independent predictor of cardiovascular mortality (exp 
      beta = 1.13, 95% confidence interval [CI] 1.05 to 1.21, two-sided p < 0.001). We 
      conclude that untreated OSA is associated with an increased risk of 
      cardiovascular mortality in patients with CAD. Furthermore, it appears 
      appropriate that RDI is taken into consideration when evaluating secondary 
      prevention models in CAD.
FAU - Peker, Y
AU  - Peker Y
AD  - Departments of Pulmonary Medicine and Clinical Pharmacology, Sahlgrenska 
      University Hospital, Gothenburg, Sweden. yuksel.peker@hjl.gu.se
FAU - Hedner, J
AU  - Hedner J
FAU - Kraiczi, H
AU  - Kraiczi H
FAU - Loth, S
AU  - Loth S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Respir Crit Care Med
JT  - American journal of respiratory and critical care medicine
JID - 9421642
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Disease/*complications/*mortality/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Sleep Apnea, Obstructive/*complications/physiopathology
EDAT- 2000/07/21 11:00
MHDA- 2000/09/19 11:01
CRDT- 2000/07/21 11:00
PHST- 2000/07/21 11:00 [pubmed]
PHST- 2000/09/19 11:01 [medline]
PHST- 2000/07/21 11:00 [entrez]
AID - 10.1164/ajrccm.162.1.9905035 [doi]
PST - ppublish
SO  - Am J Respir Crit Care Med. 2000 Jul;162(1):81-6. doi: 
      10.1164/ajrccm.162.1.9905035.