Department of Cardiology, National University Heart Centre, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
J Clin Sleep Med. 2013 Dec 15;9(12):1267-72. doi: 10.5664/jcsm.3266.
We assessed whether excessive daytime sleepiness was associated with coronary plaque phenotype and subsequent adverse cardiovascular events.
Prospective cohort study. Intravascular ultrasound (IVUS) examination of the culprit coronary stenosis was performed. The Epworth Sleepiness Scale (ESS) questionnaire was administered, and the patients were divided into 2 groups-(1) sleepier and (2) less sleepy-based on the ESS score. Adverse cardiovascular outcomes were defined as cardiac death, myocardial infarction, stroke, unplanned revascularization, or heart failure admission.
One hundred seventeen patients undergoing urgent or non-urgent coronary angiography were recruited. Compared with the less sleepy group (ESS ≤ 10, n = 87), the sleepier group (ESS > 10, n = 30) had higher serum levels of total cholesterol and of low-density-lipoprotein cholesterols (p < 0.05 for both). The IVUS examinations indicated coronary stenoses were longer in the sleepier group than in the less sleepy group (p = 0.011). The cumulative incidence of adverse cardiovascular events at 16-month follow-up was higher in the sleepier than the less sleepy group (12.5% versus 6.9%, p = 0.03). Cox regression analysis adjusting for age and smoking showed increased hazard of adverse cardiovascular events in sleepier group as compared to less sleepy group (HR = 3.44, 95% CI 1.01-11.72).
In patients presenting with coronary artery disease, excessive daytime sleepiness based on ESS > 10 was associated with longer culprit lesions and future adverse cardiovascular events.
我们评估日间过度嗜睡是否与冠状动脉斑块表型及随后的不良心血管事件有关。
前瞻性队列研究。对罪犯冠状动脉狭窄进行血管内超声（IVUS）检查。进行 Epworth 嗜睡量表（ESS）问卷调查，并根据 ESS 评分将患者分为 2 组：（1）嗜睡组（ESS＞10），（2）非嗜睡组（ESS≤10）。不良心血管结局定义为心脏死亡、心肌梗死、卒中和心力衰竭入院、计划外血运重建。
共招募了 117 例行紧急或非紧急冠状动脉造影的患者。与非嗜睡组（ESS≤10，n=87）相比，嗜睡组（ESS＞10，n=30）的总胆固醇和低密度脂蛋白胆固醇水平更高（均 p＜0.05）。IVUS 检查显示嗜睡组的冠状动脉狭窄更长（p=0.011）。在 16 个月的随访中，嗜睡组的不良心血管事件累积发生率高于非嗜睡组（12.5%比 6.9%，p=0.03）。调整年龄和吸烟因素的 Cox 回归分析显示，与非嗜睡组相比，嗜睡组不良心血管事件的发生风险更高（HR=3.44，95%CI 1.01-11.72）。
在患有冠状动脉疾病的患者中，基于 ESS＞10 的日间过度嗜睡与罪犯病变长度较长和未来不良心血管事件相关。
