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急性冠状动脉综合征患者阻塞性睡眠呼吸暂停的患病率:系统评价和荟萃分析。

Prevalence of obstructive sleep apnoea in acute coronary syndrome patients: systematic review and meta-analysis.

机构信息

Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia.

Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia.

出版信息

BMC Cardiovasc Disord. 2020 Mar 24;20(1):147. doi: 10.1186/s12872-020-01430-3.

Abstract

BACKGROUND

Obstructive Sleep Apnoea (OSA) has been recognised as a risk factor for cardiovascular diseases such as hypertension and cardiovascular events such as acute coronary syndrome (ACS). Since it is also known to reduce exercise tolerance, it is important to establish the prevalence of OSA in ACS patients, particularly in those who are commencing cardiac rehabilitation (CR) programs.

METHODS

Using PRISMA guidelines a systematic search was conducted in order to identify studies that objectively measured (using polysomnography or portable monitoring) the prevalence of OSA in ACS patients following hospital admission. A data extraction table was used to summarise study characteristics and the quality of studies were independently assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Meta-analysis of the selected studies was conducted in order to estimate OSA prevalence as a function of the two main methods of measurement, the severity of OSA, and timing of the OSA assessment following ACS hospital admission.

RESULTS

Pooled prevalence estimates of OSA using the "gold standard" polysomnography ranged from 22% for severe OSA to 70% for mild OSA, at any time after hospital admission. Similar prevalence estimates were obtained using portable monitoring, but interpretation of these results are limited by the significant heterogeneity observed among these studies.

CONCLUSIONS

Prevalence of OSA following ACS is high and likely to be problematic upon patient entry into CR programs. Routine screening for OSA upon program entry may be necessary to optimise effectiveness of CR for these patients.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)已被认为是高血压和急性冠状动脉综合征(ACS)等心血管事件等心血管疾病的危险因素。由于它也被认为会降低运动耐量,因此在 ACS 患者中确定 OSA 的患病率很重要,特别是在开始心脏康复(CR)计划的患者中。

方法

使用 PRISMA 指南进行了系统搜索,以确定在住院后客观测量(使用多导睡眠图或便携式监测)ACS 患者 OSA 患病率的研究。使用数据提取表总结研究特征,并使用 Joanna Briggs 研究所流行率关键评估工具独立评估研究质量。对选定的研究进行荟萃分析,以估计 OSA 患病率作为两种主要测量方法、OSA 严重程度和 ACS 住院后 OSA 评估时间的函数。

结果

使用“金标准”多导睡眠图进行 OSA 的汇总患病率估计值在任何时间点从严重 OSA 的 22%到轻度 OSA 的 70%不等。使用便携式监测获得了类似的患病率估计值,但这些研究中观察到的显著异质性限制了对这些结果的解释。

结论

ACS 后 OSA 的患病率很高,并且在患者进入 CR 计划时可能会出现问题。在计划开始时对 OSA 进行常规筛查可能是优化这些患者 CR 效果所必需的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/462f/7092582/0d8bbff13974/12872_2020_1430_Fig1_HTML.jpg

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