Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China.
Ann Noninvasive Electrocardiol. 2022 Sep;27(5):e12995. doi: 10.1111/anec.12995. Epub 2022 Jul 27.
The present study aimed to investigate the circadian rhythm and clinical characteristics of patients with acute myocardial infarction (AMI) combined with obstructive sleep apnea (OSA).
Patients with AMI combined with OSA were enrolled in the study, and those that met the inclusion criteria were divided into three time-period groups based on their sleep-wake rhythm (22:00-5:59, 6:00-13:59, and 14:00-21:59). The differences between the three groups of patients in sleep-monitoring data, blood routine, biochemical indicators, and coronary angiographic parameters were analyzed and compared. Count data were expressed as the number of cases, and the chi-square test was used for statistical analysis. Continuous data were expressed as mean ± standard deviation, and analysis of variance was used for the statistical analysis of these data. The characteristics of circadian rhythm and clinical features in patients with AMI combined with OSA were analyzed.
Of the 148 patients, 90/148 (61%) had chest pain and 58/148 (39%) had non-chest pain symptoms. In the 22:00-05:59 group, there were 70/148 (47%) patients with AMI (of these, 46/70 [66%] had chest pain). In the 06:00-13:59 period group, there were 44/148 (30%) patients with AMI (of these, 26/44 [60%] had chest pain). In the 14:00-21:59 period group, there were 34/148 (23%) patients with AMI (of these, 17/34 [50%] had chest pain). There was no statistically significant difference in the apnea-hypopnea index (AHI) and SYNTAX score between patients in the 22:00-5:59 and 6:00-13:59 groups. However, the AHI and SYNTAX scores in the 22:00-5:59 and 6:00-13:59 groups were higher than those in the 14:00-21:59 group, and the differences were statistically significant. In patients in the 22:00-5:59 group, the levels of serum D-dimer (DD), hemoglobin (Hb), and oxygen desaturation index (ODI3) were higher, the sleep mean oxygen saturation (MeanSaO ) was lower and the percentage of nighttime spent with oxygen saturation of less than 90% (Tsat ) and less than 85% (Tsat ) was longer.
The peak period for the onset of AMI in patients with OSA was 22:00-5:59, and the incidence of chest pain was high. During this period, patients had higher DD and Hb, higher ODI3, lower MeanSaO during sleep, and longer TSat and TSat . During the 22:00-5:59 and 6:00-13:59 periods, patients had higher AHI and a higher SYNTAX score.
本研究旨在探讨急性心肌梗死（AMI）合并阻塞性睡眠呼吸暂停（OSA）患者的昼夜节律和临床特征。
纳入 AMI 合并 OSA 的患者，根据睡眠-觉醒节律将符合纳入标准的患者分为三组：22:00-5:59、6:00-13:59 和 14:00-21:59。分析比较三组患者的睡眠监测数据、血常规、生化指标和冠状动脉造影参数的差异。计数资料用例数表示，采用卡方检验进行统计学分析。连续数据用均数±标准差表示，采用方差分析进行统计学分析。分析 AMI 合并 OSA 患者昼夜节律和临床特征的特点。
148 例患者中，90/148（61%）有胸痛，58/148（39%）无胸痛症状。22:00-05:59 组中，70/148（47%）例 AMI（其中 46/70[66%]有胸痛）。06:00-13:59 组中，44/148（30%）例 AMI（其中 26/44[60%]有胸痛）。14:00-21:59 组中，34/148（23%）例 AMI（其中 17/34[50%]有胸痛）。22:00-5:59 组和 6:00-13:59 组的呼吸暂停低通气指数（AHI）和 SYNTAX 评分无统计学差异。然而，22:00-5:59 组和 6:00-13:59 组的 AHI 和 SYNTAX 评分均高于 14:00-21:59 组，差异有统计学意义。在 22:00-5:59 组患者中，血清 D-二聚体（DD）、血红蛋白（Hb）和氧减指数（ODI3）水平较高，睡眠平均氧饱和度（MeanSaO ）较低，夜间血氧饱和度低于 90%（Tsat ）和低于 85%（Tsat ）的时间较长。
OSA 患者 AMI 的发病高峰时间为 22:00-5:59，胸痛发生率较高。在此期间，患者的 DD 和 Hb 较高，ODI3 较高，睡眠时 MeanSaO 较低，TSat 和 Tsat 较长。在 22:00-5:59 组和 6:00-13:59 组，患者的 AHI 较高，SYNTAX 评分较高。
