[The relation between obstructive sleep apnea hypopnea syndrome and the severity of coronary atherosclerosis in coronary artery disease].

OBJECTIVE

To investigate the relation between obstructive sleep apnea hypopnea syndrome (OSAHS) and the Gensini score, which is given to define the severity of coronary atherosclerosis, based on coronary angiograms findings, in patients with coronary artery disease.

METHODS

We examined the apnea hypopnea index (AHI) using polysomnography (PSG) in 231 consecutive patients with coronary artery disease (ejection fraction, > 40%) that was diagnosed by coronary angiography, 160 patients with angina pectoris and 71 patients with myocardial infarction. The Gensini score was calculated for each patient from the coronary arteriogram. The patients were classified into the following four groups according to the AHI, serious group: AHI > 40 events per hour, 44 patients; moderate group: 20 events per hour < AHI < or = 40 events per hour, 67 patients; mild group: 10 events per hour < or = AHI < or = 20 events per hour, 57 patients; OSAHS (-) group: AHI < 10 events per hour, 63 patients. Then the groups were examined for the relation between the AHI and the Gensini score.

RESULTS

Of the total number of patients, 72. 72% (168/231) had an AHI of more than ten per hour. The prevalence of multivessel disease ( > or = 3 vessels) was 75.00% (33/44)in serious group, 61.12% (41/67)in moderate group, 38.60% (22/57) in mild group, and 30.16% (19/63) in OSAHS(-) group. The Gensini score was significantly higher in serious group than the other three groups. The Gensini score was higher in moderate group than mild group and OSAHS (-) group, and the Gensini score in mild group was higher than that in OSAHS (-) group. The Gensini score showed a significant positive correlation with the AHI (r = 0.561, P < 0.001) in all patients. Multiple regression analysis showed that AHI was the most significant, independent determinant of the Gensini score among the coronary risk factors tested, and that it explained 31.4% of the variances.

CONCLUSION

These findings suggest that AHI which is used to assess the severity of OSAHS is an important contributor to coronary atherosclerosis in the patients with cardiovascular disease, and the patients with more serious OSAHS would have more serious and complex coronary artery lesions.