Department of Cardiology, Xinxiang Central Hospital, The Fourth Clinical College of 91593Xinxiang Medical University, Henan Province, People's Republic of China.
Department of Intensive Care Unit, Xinxiang Central Hospital, The Fourth Clinical College of 91593Xinxiang Medical University, Henan Province, People's Republic of China.
Ear Nose Throat J. 2021 May;100(4):260-270. doi: 10.1177/0145561321989450. Epub 2021 Feb 11.
The impact of obstructive sleep apnea (OSA) on subsequent cardiovascular events in patients with acute coronary syndrome (ACS) remains inconclusive.
Our aim was to systematically assess the relationship between preexisting OSA and adverse cardiovascular events in patients with newly diagnosed ACS by conducting a systematic review and meta-analysis.
We systematically searched PubMed, EMBASE, and Cochrane library for studies published up to May 1, 2020, that reported any association between OSA and cardiovascular events in patients with newly diagnosed ACS. The main outcomes were a composite of all-cause or cardiovascular death, recurrent myocardial infarction, stroke, repeat revascularization, or heart failure. We conducted a pooled analysis using the random-effects model. We also performed subgroup, sensitivity, heterogeneity analysis, and the assessment of publication bias.
We identified 10 studies encompassing 3350 participants. The presence of OSA was associated with increased risk of adverse cardiovascular events in newly prognosed ACS (risk ratio [RR] 2.18, 95% confidence interval [CI]: 1.45-3.26, < .001, = 64%). Between-study heterogeneity was partially explained by a multicenter study (9 single-center studies, RR 2.33 95% CI 1.69-3.19, =18%), and remarkably decreased from 64% to 18%. Moreover, OSA significantly increased the incidence of repeat revascularization (8 studies) and heart failure (6 studies) in patients with newly diagnosed ACS.
Patients with preexisting OSA are at greater risk of subsequent cardiovascular events after onset of ACS. Further studies should investigate the treatment of OSA in patient with ACS.
阻塞性睡眠呼吸暂停（OSA）对急性冠状动脉综合征（ACS）患者后续心血管事件的影响尚无定论。
通过系统评价和荟萃分析，评估新诊断为 ACS 的患者中存在的 OSA 与不良心血管事件之间的关系。
我们系统地检索了 PubMed、EMBASE 和 Cochrane 图书馆，以获取截至 2020 年 5 月 1 日发表的报告新诊断为 ACS 的患者中 OSA 与心血管事件之间任何关联的研究。主要结局为全因或心血管死亡、复发性心肌梗死、卒中和再次血运重建或心力衰竭的复合结局。我们使用随机效应模型进行了汇总分析。我们还进行了亚组、敏感性、异质性分析和发表偏倚评估。
我们确定了 10 项研究，共纳入 3350 名参与者。存在 OSA 与新诊断为 ACS 的不良心血管事件风险增加相关（风险比 [RR] 2.18，95%置信区间 [CI]：1.45-3.26，<0.001， = 64%）。研究间异质性部分由一项多中心研究解释（9 项单中心研究，RR 2.33 95% CI 1.69-3.19， =18%），且从 64%显著降低至 18%。此外，OSA 显著增加了新诊断为 ACS 患者的再次血运重建（8 项研究）和心力衰竭（6 项研究）的发生率。
患有 OSA 的患者在 ACS 发作后发生后续心血管事件的风险更高。应进一步研究 ACS 患者中 OSA 的治疗方法。
