PMID- 31792908
OWN - NLM
STAT- MEDLINE
DCOM- 20211123
LR  - 20211123
IS  - 1522-1709 (Electronic)
IS  - 1520-9512 (Linking)
VI  - 24
IP  - 4
DP  - 2020 Dec
TI  - Impact of severe OSA on pharmacoinvasive treatment in ST elevation myocardial 
      infarction patients.
PG  - 1357-1363
LID - 10.1007/s11325-019-01975-4 [doi]
AB  - PURPOSE: The negative association between obstructive sleep apnea (OSA) and 
      adverse cardiovascular outcomes in patients undergoing percutaneous coronary 
      intervention (PCI) is well documented. However, little is known about the 
      influence of OSA on fibrinolytic therapy. The aim of this study was to evaluate 
      the impact of severe OSA on pharmacoinvasive treatment in ST elevation myocardial 
      infarction (STEMI) patients. METHODS: We enrolled consecutive STEMI patients 
      without previous vascular disease, heart failure, or OSA diagnosis. All patients 
      underwent either a pharmacoinvasive therapy or primary PCI. Syntax score (SS) was 
      calculated for all patients, and a full bedside polysomnography was performed in 
      the first 72 h of admission. In-hospital events and 30 days readmissions were 
      analyzed. RESULTS: The sample included 116 patients, 87 men. Patients with severe 
      OSA were older (p = 0.01), had higher neck and abdominal circumferences 
      (p < 0.01), and had higher BMI (p < 0.01). They also had lower reperfusion rates 
      post-fibrinolysis (20 vs. 65%; p = 0.001), higher SS (20.2 +/- 11.2 vs. 
      14.6 +/- 10.6; p = 0.03), lower left ventricle ejection fraction (45 +/- 8 vs. 
      51 +/- 10%; p = 0.02), and a higher incidence of atrial arrhythmias (4 vs. 21%; 
      p = 0.02). STEMI patients with severe OSA presented with threefold increase in 
      the risk for at least one adverse outcome. Regression analysis showed that both 
      severe OSA and hypertension were independent predictors of higher SS. CONCLUSION: 
      Severe OSA was associated with a poor outcome after pharmacoinvasive treatment in 
      STEMI patients.
FAU - Maroja, Fabrizio
AU  - Maroja F
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - Caixeta, Adriano
AU  - Caixeta A
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
AD  - Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.
FAU - Poyares, Dalva
AU  - Poyares D
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - Tufik, Sergio
AU  - Tufik S
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - de Paola, Angelo
AU  - de Paola A
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - Castro, Laura
AU  - Castro L
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - Storti, Luciana
AU  - Storti L
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - Burke, Patrick
AU  - Burke P
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil.
FAU - Cintra, Fatima
AU  - Cintra F
AUID- ORCID: 0000-0002-3361-7061
AD  - Medicine Department, Universidade Federal de Sao Paulo, Rua Botucatu, 740, Vila 
      Clementino, Sao Paulo, SP, Brazil. fdumascluiz@gmail.com.
LA  - eng
GR  - 2014/Associacao Fundo de Incentivo a Pesquisa/
PT  - Journal Article
DEP - 20191202
PL  - Germany
TA  - Sleep Breath
JT  - Sleep & breathing = Schlaf & Atmung
JID - 9804161
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Female
MH  - Fibrinolytic Agents/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/*complications/*drug therapy
MH  - Sleep Apnea, Obstructive/*complications
MH  - Thrombolytic Therapy/*adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Fibrinolysis
OT  - Obstructive sleep apnea
EDAT- 2019/12/04 06:00
MHDA- 2021/11/24 06:00
CRDT- 2019/12/04 06:00
PHST- 2019/06/06 00:00 [received]
PHST- 2019/11/07 00:00 [accepted]
PHST- 2019/11/04 00:00 [revised]
PHST- 2019/12/04 06:00 [pubmed]
PHST- 2021/11/24 06:00 [medline]
PHST- 2019/12/04 06:00 [entrez]
AID - 10.1007/s11325-019-01975-4 [pii]
AID - 10.1007/s11325-019-01975-4 [doi]
PST - ppublish
SO  - Sleep Breath. 2020 Dec;24(4):1357-1363. doi: 10.1007/s11325-019-01975-4. Epub 
      2019 Dec 2.