The purpose of this study is to compare the incidence of possible obstructive sleep apnea syndrome (OSAS) in patients with acute myocardial infarction (AMI) and normal coronary angiography to the incidence of possible OSAS in patients with MI and abnormal coronary angiography.
All patients admitted to a university hospital with the diagnosis of AMI were evaluated. AMI was defined as having 2 out of 3 criteria: Chest pain, ST elevation of > 1 mm in two contiguous leads, or elevated cardiac enzymes. Patients who underwent coronary angiography were included in the study. The subjects were asked a set of questions. The questions were scored from 1 to 3. The questions addressed the following: Epworth sleepiness scale (ESS). ESS>10 (score 1), ESS>18 (score 2), snoring (score 1), witnessed apneas (score 3), falling asleep in inappropriate situations (score 2), unrefreshed sleep (score 1), and history of OSA diagnosed by NPSG. The subjects were then classified into five classes. Class I highly unlikely to have OSA (score ≤ 1), class II unlikely to have OSA (score 2), class III likely to have OSA (score 3), class IV highly likely to have OSA (score ≥3), and class V definite OSA (OSA diagnosed by nocturnal polysomnography (NPSG)). The subjects were divided into two groups. Group I included patients with normal coronaries, whereas group II included patients with abnormal coronaries on angiography.
A total of 55 patients were included in the final data analysis. 22 subject in group I, and 33 in group II.The results are summarized in the following table.
The incidence of possible OSAS was significantly higher in patients with AMI and normal coronaries compared to patients with AMI and abnormal coronaries on angiography. 28.5% compared to 6% p value 0.035.
Patients with AMI and normal coronary angiography should be investigated for the possibility of OSAS. Those found to have high likelihood of having OSAS should be sent for NPSG and adequate treatment offered.
Michael Chalhoub, None.Age (years)BMI (Kg/m2)Male (%)Female (%)Class III/IV (%)Group1 n=2257.1±13.139.6±10415928.6Group 2 n=3366.2±11.831.1±869316P valueNSNS0.0290.0290.035
Results are mean+standard deviations unless otherwise specified. BMI= Body Mass Index.