PMID- 34366217
OWN - NLM
STAT- MEDLINE
DCOM- 20211109
LR  - 20211109
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 30
IP  - 12
DP  - 2021 Dec
TI  - Influence of Obstructive Sleep Apnoea on Outcomes in Patients With ST Elevation 
      Myocardial Infarction (STEMI): the Role of the Coronary Collateral Circulation.
PG  - 1883-1890
LID - S1443-9506(21)01150-1 [pii]
LID - 10.1016/j.hlc.2021.07.008 [doi]
AB  - BACKGROUND: Obstructive sleep apnoea (OSA) occurs frequently in patients with 
      coronary artery disease, with associated intermittent hypoxia a possible stimulus 
      for coronary collateral recruitment through ischaemic preconditioning. We sought 
      to determine whether OSA affects recruitment of coronary collaterals and 
      prognosis of patients presenting with ST elevation myocardial infarction (STEMI). 
      METHODS: Patients with a STEMI undergoing percutaneous coronary intervention 
      (PCI) from July 2010 to December 2019 were reviewed. Electronic medical records 
      were accessed to determine documented patient history of OSA. Patients with 
      robust collaterals were defined as Rentrop Grade 2 or 3. RESULTS: 1,863 patients 
      were included, of which 143 (7.7%) patients had documented evidence of OSA in 
      their health record. Patients with OSA had a higher body mass index (BMI) (30.2 
      kg/m(2) vs 27 kg/m(2), p<0.0001), greater rate of hypertension (61.1% vs 45.1%, 
      p<0.0001), hypercholesterolaemia (47.4% vs 38.4%, p<0.05) and diabetes mellitus 
      (22.6% vs 15.9%, p<0.05). Patients with OSA were more likely to have robust 
      coronary collaterals (OR: 2.2 [95% CI: 1.5-3.2]) and a lower rate of left 
      ventricular (LV) impairment (50.7% vs 63.1%, p<0.01), a higher LV ejection 
      fraction (50.3% vs 46.7%, p<0.0001) and a lower peak troponin-I level (26,452 
      ng/L vs 39,469 ng/L, p<0.01). There were no differences in rates of in-hospital 
      or longer term mortality, in patients with OSA compared to those without. 
      CONCLUSIONS: Patients with documented OSA presenting with STEMI appear to have 
      more robust coronary collaterals observed on angiography which likely mediates 
      lower myocardial necrosis. Broader implications of this finding on treatment 
      require further investigation.
CI  - Copyright (c) 2021 Australian and New Zealand Society of Cardiac and Thoracic 
      Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). 
      Published by Elsevier B.V. All rights reserved.
FAU - Allahwala, Usaid K
AU  - Allahwala UK
AD  - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia; The 
      University of Sydney, Sydney, NSW, Australia. Electronic address: 
      usaid.allahwala@sydney.edu.au.
FAU - Cistulli, Peter
AU  - Cistulli P
AD  - Centre for Sleep Health and Research, Department of Respiratory & Sleep Medicine, 
      Royal North Shore Hospital, Sydney, NSW, Australia; Sleep Research Group, Charles 
      Perkins Centre, School of Medicine, University of Sydney, Sydney, NSW, Australia.
FAU - Ciofani, Jonathan L
AU  - Ciofani JL
AD  - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia. 
      Electronic address: https://twitter.com/JonathanCiofani.
FAU - Dissanayake, Hasthi U
AU  - Dissanayake HU
AD  - Sleep Research Group, Charles Perkins Centre, School of Medicine, University of 
      Sydney, Sydney, NSW, Australia.
FAU - Ward, Michael
AU  - Ward M
AD  - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia; The 
      University of Sydney, Sydney, NSW, Australia.
FAU - Weaver, James C
AU  - Weaver JC
AD  - The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal 
      Prince Alfred Hospital, Sydney, NSW, Australia.
FAU - Bhindi, Ravinay
AU  - Bhindi R
AD  - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia; The 
      University of Sydney, Sydney, NSW, Australia. Electronic address: 
      https://twitter.com/Ravinay.
LA  - eng
PT  - Journal Article
DEP - 20210805
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Collateral Circulation
MH  - Coronary Angiography
MH  - Coronary Circulation
MH  - Humans
MH  - *Percutaneous Coronary Intervention
MH  - *ST Elevation Myocardial Infarction/complications/diagnosis/surgery
MH  - *Sleep Apnea, Obstructive/complications/diagnosis/epidemiology
OTO - NOTNLM
OT  - Coronary collaterals
OT  - Obstructive sleep apnoea
OT  - ST elevation myocardial infarction
OT  - STEMI
EDAT- 2021/08/10 06:00
MHDA- 2021/11/10 06:00
CRDT- 2021/08/09 05:41
PHST- 2020/10/08 00:00 [received]
PHST- 2021/06/07 00:00 [revised]
PHST- 2021/07/06 00:00 [accepted]
PHST- 2021/08/10 06:00 [pubmed]
PHST- 2021/11/10 06:00 [medline]
PHST- 2021/08/09 05:41 [entrez]
AID - S1443-9506(21)01150-1 [pii]
AID - 10.1016/j.hlc.2021.07.008 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2021 Dec;30(12):1883-1890. doi: 10.1016/j.hlc.2021.07.008. Epub 
      2021 Aug 5.