Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Anzhen Hospital Affiliated Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing 100029, China.
Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Anzhen Hospital Affiliated Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing 100029, China.
Sleep Med. 2024 Mar;115:131-136. doi: 10.1016/j.sleep.2024.02.004. Epub 2024 Feb 10.
Excessive daytime sleepiness (EDS) frequently accompanies obstructive sleep apnea (OSA) and may increase cardiovascular risks. The majority of coronary artery disease (CAD) patients receive understandard treatments, it is not clear whether EDS is associated with increased residual cardiovascular risks in CAD patients with OSA.
This study is a prospective cohort study that included 1215 consecutive CAD patients underwent overnight sleep study with a 3.7 year follow-up. Sleepiness was is determined by the Epworth Sleepiness Scale questionnaire. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, myocardial infarction, stroke, and heart failure. Kaplan-Meier model and Cox proportional hazards models were used to explore the relationship between residual cardiovascular risks and EDS.
1027 cases were eventually enrolled, and a total of 129 patients experienced cardiovascular and cerebrovascular events. Participants with EDS had a higher risk of MACCE compared to those without EDS (17.02% vs. 9.58%, P = 0.005). The presence of EDS is associated with higher incidence of MACCE compared to non-EDS patients (HR 2.833; 95%CI:1.394-5.762; P < 0.001). EDS was significantly associated with increased incidence of MACCE in OSA patients (HR 1.765; 95%CI:1.276-2.543; P = 0.193), while there was no significant association between EDS and cardiovascular risks in non-OSA patients (HR 1.233; 95%CI: 0.893-2.755; P = 0.127).
The existence of EDS may lead to increased cardiovascular risks, EDS is associated with increased cardiovascular risks in CAD patients, especially in patients with OSA.
日间嗜睡（EDS）常伴有阻塞性睡眠呼吸暂停（OSA），并可能增加心血管风险。大多数冠状动脉疾病（CAD）患者接受标准治疗，但尚不清楚 EDS 是否与 OSA 合并 CAD 患者的残余心血管风险增加有关。
这是一项前瞻性队列研究，纳入了 1215 例连续接受过夜睡眠研究并随访 3.7 年的 CAD 患者。嗜睡通过 Epworth 嗜睡量表问卷确定。主要终点是主要不良心血管和脑血管事件（MACCE），包括心血管死亡、心肌梗死、卒中和心力衰竭。Kaplan-Meier 模型和 Cox 比例风险模型用于探讨残余心血管风险与 EDS 之间的关系。
最终纳入 1027 例患者，共 129 例发生心血管和脑血管事件。与无 EDS 患者相比，EDS 患者发生 MACCE 的风险更高（17.02% vs. 9.58%，P=0.005）。与非 EDS 患者相比，存在 EDS 与 MACCE 的发生率更高相关（HR 2.833；95%CI：1.394-5.762；P<0.001）。在 OSA 患者中，EDS 与 MACCE 的发生率增加显著相关（HR 1.765；95%CI：1.276-2.543；P=0.193），而在非 OSA 患者中，EDS 与心血管风险之间无显著相关性（HR 1.233；95%CI：0.893-2.755；P=0.127）。
EDS 的存在可能导致心血管风险增加，EDS 与 CAD 患者的心血管风险增加有关，尤其是在 OSA 患者中。
