Yarlioglues Mikail, Karacali Kadir, Ilhan Bilal Canberk, Yalcinkaya Oner Damla
Department of Cardiology, Ankara Training and Research Hospital, Ankara, Turkey.
Department of Cardiology, Ankara Training and Research Hospital, Ankara, Turkey.
Sleep Med. 2024 Apr;116:56-61. doi: 10.1016/j.sleep.2024.02.039. Epub 2024 Feb 28.
Previous studies reported that sleeping disorders were associated with presence and severity of coronary artery disease (CAD). We aimed to evaluate the relationship between the angiographic progression of CAD with sleep quality.
We enrolled 690 patients who had angiography history with diagnosis of chronic CAD, requiring new angiography according to clinical, and laboratory evaluation among 1654 patients with complaint of stable angina. Previous and new coronary angiography images of patients were compared to evaluate the presence of angiographic progression using quantitative coronary analysis measurement. A 1:2 propensity score matching was performed. Thus, the patient population was divided into two groups including non-progressors group (n = 156) and progressors group (n = 78). Groups were compared in terms of sleep quality and disorder using Pittsburgh Sleep Quality Index (PSQI) and STOP-Bang questionnaire.
Progressors had shorter sleep duration, higher PSQI score indicating poorer sleep quality and higher STOP BANG score indicating increased sleep apnea risk than non-progressors (p < 0.05). The multivariate logistic regression analysis determined that night shift work (OR: 1.38, p = 0.04), sleep duration difference (OR: 1.25, p = 0.03), poorer sleep quality (OR: 2.08, p = 0.01), high STOP BANG score (OR: 1.86, p = 0.004), and high risk of sleep apnea (OR: 3.84, p = 0.008) were independently associated with significant risk of angiographic CAD progression.
Our findings suggested that angiographically proven chronic CAD progression was associated with poor sleep quality including high apnea risk. Selected patients should be subjected to an advanced evaluation including sleep study to diagnose sleep disorders such as sleep apnea. Treatment of sleep disorders can support existing medical and/or invasive treatments in chronic CAD and improve outcomes.
既往研究报道睡眠障碍与冠状动脉疾病（CAD）的存在及严重程度相关。我们旨在评估CAD血管造影进展与睡眠质量之间的关系。
我们纳入了690例有血管造影史且诊断为慢性CAD的患者，这些患者来自1654例主诉稳定型心绞痛的患者，根据临床及实验室评估需要进行新的血管造影。比较患者之前和新的冠状动脉造影图像，采用定量冠状动脉分析测量来评估血管造影进展情况。进行了1:2倾向评分匹配。因此，患者群体被分为两组，包括非进展组（n = 156）和进展组（n = 78）。使用匹兹堡睡眠质量指数（PSQI）和STOP - Bang问卷对两组的睡眠质量和障碍进行比较。
与非进展组相比，进展组的睡眠时间更短，PSQI评分更高表明睡眠质量更差，STOP BANG评分更高表明睡眠呼吸暂停风险增加（p < 0.05）。多因素逻辑回归分析确定，夜班工作（比值比：1.38，p = 0.04）、睡眠时间差异（比值比：1.25，p = 0.03）、睡眠质量较差（比值比：2.08，p = 0.01）、高STOP BANG评分（比值比：1.86，p = 0.004）以及高睡眠呼吸暂停风险（比值比：3.84，p = 0.008）与血管造影CAD进展的显著风险独立相关。
我们的研究结果表明，血管造影证实的慢性CAD进展与包括高呼吸暂停风险在内的睡眠质量差有关。对于选定的患者，应进行包括睡眠研究在内的进一步评估，以诊断睡眠呼吸暂停等睡眠障碍。睡眠障碍的治疗可以辅助慢性CAD现有的药物和/或侵入性治疗，并改善预后。
