Department of Cardiology, Medipol İstanbul University, İstanbul, Turkey.
Department of Cardiology, Sivas Cumhuriyet University, Sivas, Turkey.
Coron Artery Dis. 2024 Jun 1;35(4):299-308. doi: 10.1097/MCA.0000000000001337. Epub 2024 Apr 24.
To investigate the relationship between coronary artery lesion severity determined using the baseline SYNTAX score and sleep problems that might occur after discharge determined using the Pittsburgh Sleep Quality Index (PSQI).
This prospective study included patients with first acute coronary syndrome (ACS) who underwent percutaneous coronary angiography between February 2019 and August 2019. The severity of coronary artery stenosis was classified according to coronary angiography and SYNTAX scores. Patients were grouped as those with a SYNTAX score of ≤22 and >22. Sleep quality after discharge was classified according to the PSQI. PSQI ≤5 represented good sleep quality, and PSQI >5 represented poor sleep quality. Univariate and multivariate logistic regression was used to investigate the relationship between sleep quality and coronary artery stenosis severity.
A total of 424 patients were included in the study. Of these, 294 (69.34%) had a SYNTAX score of ≤22 and 130 (30.66%) had a SYNTAX score of >22. The mean age of all patients was 60.37 ± 12.23 years, 59.69 ± 11.85 years in the SYNTAX ≤22 groups and 61.90 ± 12.98 years in the SYNTAX >22 group (P = 0.086). The majority (78.54%) of the patients were male and there was no significant difference between the SYNTAX ≤22 group and the SYNTAX >22 group in terms of sex distribution (P = 0.383). According to the univariate logistic regression analysis, age (P = 0.014), diabetes (P = 0.027), left ventricular ejection fraction (P = 0.001), estimated glomerular filtration rate (P = 0.039), creatine kinase MB (P = 0.040) and SYNTAX scores (P < 0.001) were significantly associated with high PSQI global scores (>5). However, according to the multivariate logistic regression analysis results, high (>22) SYNTAX scores were the only factor independently associated with the high (>5) PSQI global scores [odds ratio, 3.477; 95% confidence interval (CI), (2.190-5.522); P < 0.001]. Complete revascularization group had significantly higher sleep latency and sleep duration time, sleep efficiency and the percentage of patients with PSQI global score of ≤5 than the incomplete revascularization group (P < 0.001 for all).
Among patients with ACS, those with high SYNTAX scores should be monitored more carefully for sleep disorders that may occur later.
探讨基线 SYNTAX 评分确定的冠状动脉病变严重程度与使用匹兹堡睡眠质量指数（PSQI）确定的出院后可能出现的睡眠问题之间的关系。
本前瞻性研究纳入了 2019 年 2 月至 2019 年 8 月间接受经皮冠状动脉造影术的首次急性冠状动脉综合征（ACS）患者。根据冠状动脉造影和 SYNTAX 评分对冠状动脉狭窄严重程度进行分类。根据 SYNTAX 评分将患者分为 SYNTAX 评分≤22 分和>22 分两组。根据 PSQI 对出院后的睡眠质量进行分类。PSQI≤5 表示睡眠质量良好，PSQI>5 表示睡眠质量差。使用单变量和多变量逻辑回归分析睡眠质量与冠状动脉狭窄严重程度之间的关系。
本研究共纳入 424 例患者，其中 294 例（69.34%）SYNTAX 评分≤22 分，130 例（30.66%）SYNTAX 评分>22 分。所有患者的平均年龄为 60.37±12.23 岁，SYNTAX≤22 组为 59.69±11.85 岁，SYNTAX>22 组为 61.90±12.98 岁（P=0.086）。大多数（78.54%）患者为男性，SYNTAX≤22 组和 SYNTAX>22 组在性别分布方面无显著差异（P=0.383）。根据单变量逻辑回归分析，年龄（P=0.014）、糖尿病（P=0.027）、左心室射血分数（P=0.001）、估算肾小球滤过率（P=0.039）、肌酸激酶同工酶 MB（P=0.040）和 SYNTAX 评分（P<0.001）与 PSQI 总分（>5）显著相关。然而，根据多变量逻辑回归分析结果，高（>22）SYNTAX 评分是唯一与 PSQI 总分（>5）显著相关的因素[比值比，3.477；95%置信区间（CI），（2.190-5.522）；P<0.001]。完全血运重建组的睡眠潜伏期、睡眠时间、睡眠效率以及 PSQI 总分≤5 的患者比例均显著高于不完全血运重建组（所有 P<0.001）。
在 ACS 患者中，SYNTAX 评分较高的患者应更密切地监测可能随后出现的睡眠障碍。
