Porto Fernanda, Sakamoto Yuri Saho, Salles Cristina
Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brazil.
Arq Bras Cardiol. 2017 Apr;108(4):361-369. doi: 10.5935/abc.20170031. Epub 2017 Mar 30.
Obstructive sleep apnea (OSA) has been associated to cardiovascular risk factors. However, the association between OSA and cardiovascular disease is still controversial. The objective of the present study was to verify the association between OSA and myocardial infarction (MI). This is a systematic review of the literature performed through electronic data sources MEDLINE/PubMed, PubMed Central, Web of Science and BVS -Biblioteca Virtual em Saúde (Virtual Health Library). The descriptors used were: 'obstructive sleep apnea' AND 'polysomnography' AND 'myocardial infarction' AND 'adults NOT 'treatment.' The present work analysed three prospective studies, selected from 142 articles. The studies followed a total sample of 5,067 OSA patients, mostly composed by male participants. All patients underwent night polysomnography, and all studies found an association between OSA and fatal and non-fatal cardiovascular outcomes. Thus, we were able to observe that 644 (12.7%) of the 5,067 patients suffered MI or stroke, or required a revascularization procedure, and 25.6% of these cardiovascular events were fatal. MI was responsible for 29.5% of all 644 analysed outcomes. There is an association between OSA and MI, in male patients, and apnea and hypopnea index (AHI) are the most reliable markers.
阻塞性睡眠呼吸暂停（OSA）与心血管危险因素相关。然而，OSA与心血管疾病之间的关联仍存在争议。本研究的目的是验证OSA与心肌梗死（MI）之间的关联。这是一项通过电子数据源MEDLINE/PubMed、PubMed Central、科学网和BVS-虚拟健康图书馆（Virtual Health Library）进行的文献系统综述。使用的描述词为：“阻塞性睡眠呼吸暂停”且“多导睡眠图”且“心肌梗死”且“成年人”而非“治疗”。本研究分析了从142篇文章中筛选出的三项前瞻性研究。这些研究共纳入了5067例OSA患者，其中大多数为男性参与者。所有患者均接受了夜间多导睡眠图检查，所有研究均发现OSA与致命和非致命心血管结局之间存在关联。因此，我们观察到，在5067例患者中，有644例（12.7%）发生了MI或中风，或需要进行血管重建手术，其中25.6%的心血管事件是致命的。MI占所有644例分析结局的29.5%。在男性患者中，OSA与MI之间存在关联，呼吸暂停低通气指数（AHI）是最可靠的标志物。
