Rabec Claudio, Sombrun Chan, Bentounes Sid Ahmed, Georges Marjolaine, Bisson Arnaud, Bichat Florence, Bodin Alexandre, Herbert Julien, Zeller Marianne, Cottin Yves, Fauchier Laurent
Pneumology Department, CHU Dijon Bourgogne, 21000 Dijon, France.
Cardiology Department, CHU Dijon Bourgogne, 21000 Dijon, France.
J Clin Med. 2023 Sep 12;12(18):5924. doi: 10.3390/jcm12185924.
. Sleep apnea (SA) is a common breathing disorder characterized by repetitive upper airway narrowing and closure. Although SA has been demonstrated to be an independent risk factor for all-cause mortality, the direct contribution of SA to worse cardiovascular prognosis may be difficult to evaluate, and its independent association with the different types of cardiovascular outcomes may be debated, particularly in the context of patients with acute myocardial infarction (AMI). The aim of this study was to assess the impact of known SA on the outcomes of hospitalized patients who have had an AMI by analyzing 10-year data collected from a national registry. . This longitudinal cohort study was based on the national hospitalization database that covers hospital care for the entire French population, including all patients admitted with AMI from January 2010 to June 2019. The clinical outcomes for the analysis were as follows: all-cause death, cardiovascular death, ischemic stroke, new-onset atrial fibrillation (FA), and re-hospitalization for heart failure (HF). . Among the 797,212 patients who presented with an AMI (528,351 men and 268,861 women), 37,075 (4.7%) had documented SA. During follow-up (mean [SD] 1.8 [2.4] years, median [interquartile range] 0.7 [0.1-3.1] years), 163,845 deaths (of which 85,649 were cardiovascular deaths), 20,168 ischemic strokes, 58,498 new-onset AF, and 92,381 rehospitalizations due to HF were recorded. Patients with known SA had a worse prognosis in the short and medium term, but after adjusting for all covariables, SA was only independently associated with a higher risk of rehospitalization for HF and new-onset AF in men and women. . Data from our large nationwide analysis confirm that known SA is associated with poor cardiovascular outcomes in patients who have had an AMI. However, this impact is tem-pered when the model is adjusted for age, cardiovascular risk, or other covariables. Further studies need to be conducted to assess the independent impact of SA on the prognosis of patients with AMI.
睡眠呼吸暂停（SA）是一种常见的呼吸障碍，其特征为上呼吸道反复变窄和闭合。尽管SA已被证明是全因死亡率的独立危险因素，但SA对心血管预后恶化的直接影响可能难以评估，而且其与不同类型心血管结局的独立关联可能存在争议，尤其是在急性心肌梗死（AMI）患者的情况下。本研究的目的是通过分析从国家登记处收集的10年数据，评估已知SA对AMI住院患者结局的影响。 这项纵向队列研究基于涵盖法国全体人口住院治疗情况的国家住院数据库，包括2010年1月至2019年6月期间所有因AMI入院的患者。分析的临床结局如下：全因死亡、心血管死亡、缺血性中风、新发心房颤动（AF）以及因心力衰竭（HF）再次住院。 在797,212例出现AMI的患者（528,351例男性和268,861例女性）中，37,075例（4.7%）有记录的SA。在随访期间（平均[标准差]1.8[2.4]年，中位数[四分位间距]0.7[0.1 - 3.1]年），记录了163,845例死亡（其中85,649例为心血管死亡）、20,168例缺血性中风、58,498例新发AF以及92,381例因HF再次住院。已知SA的患者在短期和中期预后较差，但在对所有协变量进行调整后，SA仅与男性和女性因HF再次住院以及新发AF的较高风险独立相关。 我们大规模全国性分析的数据证实，已知SA与AMI患者不良的心血管结局相关。然而，当模型针对年龄、心血管风险或其他协变量进行调整时，这种影响会减弱。需要进行进一步研究以评估SA对AMI患者预后的独立影响。
