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Multicenter Study
. 2014 Sep;176(1):13-9.
doi: 10.1016/j.ijcard.2014.06.020. Epub 2014 Jun 27.

Sleep apnea prevalence in acute myocardial infarction--the Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study

Ondrej Ludka  1 , Radka Stepanova  2 , Martina Vyskocilova  2 , Lujza Galkova  1 , Monika Mikolaskova  3 , Milos Belehrad  2 , Jana Kostalova  2 , Zuzana Mihalova  4 , Adela Drozdova  4 , Jiri Hlasensky  3 , Michal Gacik  5 , Lucie Pudilova  5 , Tereza Mikusova  6 , Blanka Fischerova  6 , Fatima Sert-Kuniyoshi  7 , Virend K Somers  8 , Jindrich Spinar  1 , Tomas Kara  9
Affiliations
Multicenter Study

Sleep apnea prevalence in acute myocardial infarction--the Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study

Ondrej Ludka et al. Int J Cardiol. 2014 Sep.

Abstract

Background: While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients.

Methods: We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 h post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (<5 events/h), mild SA (5-15 events/h), moderate SA (15-30 events/h), and severe SA (≥ 30 events/h).

Results: Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥ 5 events/h, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6 AM to 12 PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12 AM to 6 AM (all p<0.05).

Conclusion: There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6 AM and noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.

Keywords: Acute myocardial infarction; Day–night variation; Prevalence; Sleep apnea.

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Figures

Figure 1
Figure 1
Prevalence of sleep apnea in patients after acute myocardial infarction
Figure 2
Figure 2
6-hour epochs of MI occurrence
Figure 3
Figure 3
6-hour epochs of MI occurrence according to gender - females are shown in upper panel (A) and males are shown in lower panel (B)
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References

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