PMID- 29249245
OWN - NLM
STAT- MEDLINE
DCOM- 20180530
LR  - 20181202
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 71
IP  - 2
DP  - 2018 Feb
TI  - Relationship between sleep-disordered breathing and renal dysfunction in acute 
      coronary syndrome.
PG  - 168-173
LID - S0914-5087(17)30219-8 [pii]
LID - 10.1016/j.jjcc.2017.07.017 [doi]
AB  - BACKGROUND: Sleep-disordered breathing (SDB) is associated with cardiovascular 
      complications. However, the effect of SDB on renal function in patients with 
      acute coronary syndrome (ACS) treated by percutaneous coronary intervention (PCI) 
      remains unclear. METHODS: We enrolled 154 consecutive ACS patients without heart 
      failure. A sleep study was performed immediately after PCI. RESULTS: The mean 
      apnea-hypopnea index (AHI) was 16.4+/-13.1, and 33 patients (21%) had severe SDB, 
      defined as AHI>/=25. Estimated glomerular filtration rate (eGFR) values on 
      admission (60+/-12mL/min/1.73m(2) vs. 67+/-17mL/min/1.73m(2), p=0.046) and at 
      discharge (54+/-15mL/min/1.73m(2) vs. 63+/-15mL/min/1.73m(2), p=0.002) were lower in 
      patients with severe SDB than in those patients without severe SDB. Multiple 
      linear regression analysis showed that AHIs were significantly correlated with 
      absolute changes in eGFR values from admission to discharge (beta=0.201, p=0.004). 
      Median 24-h urinary noradrenaline excretion measured on the same day of the sleep 
      study was higher [297 (interquartile range IQR: 232-472) vs. 174 (IQR: 
      107-318)mug/day, p=0.021] in patients with severe SDB. On multivariate logistic 
      regression analysis, the presence of severe SDB was a significant predictor 
      (adjusted odds ratio 3.76, 95% confidence interval 1.06-13.9, p=0.047) for eGFR 
      of less than 45mL/min/1.73m(2) at discharge. This association was independent of 
      age, eGFR on admission, and a presentation of ST-segment elevation myocardial 
      infarction. CONCLUSION: In patients with ACS who undergo PCI, severe SDB is 
      associated with impaired renal function on admission and its deterioration during 
      hospitalization. Further studies will be needed to conclude that SDB would be a 
      therapeutic target in ACS.
CI  - Copyright (c) 2017. Published by Elsevier Ltd.
FAU - Kiyokuni, Masayoshi
AU  - Kiyokuni M
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
FAU - Kawashima, Chika
AU  - Kawashima C
AD  - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Konishi, Masaaki
AU  - Konishi M
AD  - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. 
      Electronic address: m_koni@hotmail.com.
FAU - Sakamaki, Kentaro
AU  - Sakamaki K
AD  - Department of Biostatistics, Yokohama City University School of Medicine, 
      Yokohama, Japan.
FAU - Iwata, Kiwamu
AU  - Iwata K
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
FAU - Nakayama, Naoki
AU  - Nakayama N
AD  - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Komura, Naohiro
AU  - Komura N
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
FAU - Kosuge, Masami
AU  - Kosuge M
AD  - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Sugano, Teruyasu
AU  - Sugano T
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
FAU - Ishigami, Tomoaki
AU  - Ishigami T
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
FAU - Endo, Tsutomu
AU  - Endo T
AD  - Division of Cardiology, Saiseikai Yokohama Southern Hospital, Yokohama, Japan.
FAU - Ishikawa, Toshiyuki
AU  - Ishikawa T
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
FAU - Yamanaka, Takeharu
AU  - Yamanaka T
AD  - Department of Biostatistics, Yokohama City University School of Medicine, 
      Yokohama, Japan.
FAU - Kimura, Kazuo
AU  - Kimura K
AD  - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Tamura, Kouichi
AU  - Tamura K
AD  - Department of Medical Science and Cardiorenal Medicine, Yokohama City University 
      School of Medicine, Yokohama, Japan.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Acute Coronary Syndrome/*physiopathology/surgery
MH  - Aged
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Hospitalization
MH  - Humans
MH  - Kidney Diseases/*physiopathology
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention
MH  - Sleep Apnea Syndromes/*physiopathology
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Apnea-hypopnea index
OT  - Kidney
OT  - Renal function
OT  - Sleep-disordered breathing
EDAT- 2017/12/19 06:00
MHDA- 2018/05/31 06:00
CRDT- 2017/12/19 06:00
PHST- 2017/03/30 00:00 [received]
PHST- 2017/07/01 00:00 [revised]
PHST- 2017/07/21 00:00 [accepted]
PHST- 2017/12/19 06:00 [entrez]
PHST- 2017/12/19 06:00 [pubmed]
PHST- 2018/05/31 06:00 [medline]
AID - S0914-5087(17)30219-8 [pii]
AID - 10.1016/j.jjcc.2017.07.017 [doi]
PST - ppublish
SO  - J Cardiol. 2018 Feb;71(2):168-173. doi: 10.1016/j.jjcc.2017.07.017.