PMID- 38098080
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231217
IS  - 1465-993X (Electronic)
IS  - 1465-9921 (Print)
IS  - 1465-9921 (Linking)
VI  - 24
IP  - 1
DP  - 2023 Dec 14
TI  - Prognostic implications of obstructive sleep apnea in patients with acute 
      coronary syndrome stratified by homocysteine level: a prospective cohort study.
PG  - 313
LID - 10.1186/s12931-023-02627-8 [doi]
LID - 313
AB  - BACKGROUND: Sporadic studies have examined the impact of OSA on ACS patients by 
      homocysteine (Hcy) level. This study attempted to comprehensively evaluate the 
      effects of the interaction between Hcy and OSA on long-term cardiovascular 
      outcomes in ACS patients. METHODS: In this prospective, large-scale cohort study, 
      2160 patients admitted for ACS were recruited to undergo overnight sleep 
      monitoring. OSA was diagnosed when apnea-hypopnea index >/= 15 events/h. Patients 
      with normohomocysteinemia (NHcy) were defined as having serum Hcy </= 15 mumol/L, 
      and the others had hyperhomocysteinemia (HHcy). The primary endpoint was major 
      adverse cerebrocardiovascular event (MACCE), a composite of cardiovascular death, 
      myocardial infarction, stroke, ischemia-driven revascularization and 
      hospitalization for unstable angina and heart failure. RESULTS: A total of 1553 
      eligible ACS patients (average age: 56.3 +/- 10.5 years) were enrolled, among which 
      819 (52.7%) had OSA, and 988 (63.6%) were with NHcy. OSA did not significantly 
      affect the level of Hcy. During a median follow-up of 2.9 (1.6, 3.5) years, after 
      adjustment for clinical confounders, OSA was associated with increased risk for 
      MACCE occurrence versus non-OSA ones in ACS patients with NHcy (adjusted hazard 
      ratio [HR] = 1.36, 95% confidence interval [CI] 1.02-1.83, P = 0.039), but not in 
      those with HHcy (adjusted HR = 0.92, 95%CI 0.62-1.36, P = 0.668). There was an 
      absence of interaction between homocysteine level and OSA in relation to MACCE 
      (interaction P = 0.106). CONCLUSIONS: OSA was independently associated with worse 
      prognosis in ACS patients with NHcy. Our study emphasized the necessity to 
      identify potential presence of OSA in such a population. TRIAL REGISTRATION: 
      ClinicalTrials.gov; Number: NCT03362385; URL: www. CLINICALTRIALS: gov .
CI  - (c) 2023. The Author(s).
FAU - Chen, Xiuhuan
AU  - Chen X
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Zhen, Lei
AU  - Zhen L
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Ai, Hui
AU  - Ai H
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Que, Bin
AU  - Que B
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Fan, Jingyao
AU  - Fan J
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Wang, Xiao
AU  - Wang X
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Yan, Yan
AU  - Yan Y
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Li, Siyi
AU  - Li S
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Zhang, Zekun
AU  - Zhang Z
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Zhou, Yun
AU  - Zhou Y
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
FAU - Gong, Wei
AU  - Gong W
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China. gongwei@ccmu.edu.cn.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China. 
      gongwei@ccmu.edu.cn.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China. 
      gongwei@ccmu.edu.cn.
FAU - Nie, Shaoping
AU  - Nie S
AD  - Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen 
      Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 
      100029, China. spnie@ccmu.edu.cn.
AD  - National Clinical Research Center for Cardiovascular Diseases, Beijing, China. 
      spnie@ccmu.edu.cn.
AD  - Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China. 
      spnie@ccmu.edu.cn.
LA  - eng
SI  - ClinicalTrials.gov/NCT03362385
GR  - 82100260/National Natural Science Foundation of China/
GR  - 81970292/National Natural Science Foundation of China/
GR  - 82270258/National Natural Science Foundation of China/
GR  - 2020YFC2004800/National Key Research and Development Program of China/
PT  - Journal Article
DEP - 20231214
PL  - England
TA  - Respir Res
JT  - Respiratory research
JID - 101090633
RN  - 0LVT1QZ0BA (Homocysteine)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Prognosis
MH  - *Acute Coronary Syndrome/diagnosis/epidemiology
MH  - Prospective Studies
MH  - Cohort Studies
MH  - *Sleep Apnea, Obstructive/diagnosis/epidemiology/complications
MH  - Homocysteine
MH  - Risk Factors
PMC - PMC10722678
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Homocysteine
OT  - Obstructive sleep apnea
COIS- The authors declare that they have no competing interests.
EDAT- 2023/12/15 06:42
MHDA- 2023/12/17 17:42
PMCR- 2023/12/14
CRDT- 2023/12/15 00:23
PHST- 2023/07/26 00:00 [received]
PHST- 2023/12/04 00:00 [accepted]
PHST- 2023/12/17 17:42 [medline]
PHST- 2023/12/15 06:42 [pubmed]
PHST- 2023/12/15 00:23 [entrez]
PHST- 2023/12/14 00:00 [pmc-release]
AID - 10.1186/s12931-023-02627-8 [pii]
AID - 2627 [pii]
AID - 10.1186/s12931-023-02627-8 [doi]
PST - epublish
SO  - Respir Res. 2023 Dec 14;24(1):313. doi: 10.1186/s12931-023-02627-8.