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Observational Study
. 2021 Jul 31;21(1):366.
doi: 10.1186/s12872-021-02168-2.

The effects of high-sensitivity C-reactive protein on the clinical outcomes in obstructive sleep apnea patients undergoing off-pump coronary artery bypass grafting

Mingxin Gao  1 , Kangjun Fan  1 , Wenyuan Yu  1 , Hongli Liu  1 , Yongxiang Wei  2 , Yang Yu  3
Affiliations
Observational Study

The effects of high-sensitivity C-reactive protein on the clinical outcomes in obstructive sleep apnea patients undergoing off-pump coronary artery bypass grafting

Mingxin Gao et al. BMC Cardiovasc Disord. .

Abstract

Purpose: To investigate the relationship between obstructive sleep apnea (OSA) severity and high-sensitivity C-reactive protein (Hs-CRP), and their respective impact on the clinical outcomes in patients undergoing off-pump cardiac artery bypass grafting (OPCABG).

Methods: We enrolled consecutive eligible patients listed for elective OPCABG who underwent cardiorespiratory polygraphy before surgery between January 2019 and December 2019 in this prospective observational single-center study. Baseline, intraoperative, and postoperative clinical data were compared between absent-mild and moderate-severe OSA groups. Regression analysis investigated the relationship between Hs-CRP level and severity of OSA, and further assessed the factors influencing postoperative atrial fibrillation, duration of hospitalization, and hospital cost.

Results: Patients with moderate-severe OSA accounted for 42.3% (52/123) of the cohort. Partial pressure of carbon dioxide (PCO2), Hs-CRP, apnea hypopnea index (AHI), mean apnea time, maximum apnea time, and oxygen desaturation index ODI ≥ 3% were significantly higher in the moderate-severe OSA group than in the absent-mild OSA group. Left ventricle ejection fraction (LVEF), lowest arterial oxygen saturation (SaO2), and mean SaO2 were significantly lower in the moderate-severe OSA group. Moderate-severe OSA was associated with elevated Hs-CRP level (OR = 2.356, 95% CI 1.101-5.041, P = 0.027). Hs-CRP was an independent risk factor for post-CABG atrial fibrillation (POAF) (OR = 1.212, P = 0.01). Hs-CRP level independently correlated with duration of hospitalization (B = 0.456, P = 0.001) and hospital cost (B = 1.111, P = 0.044).

Conclusion: Hs-CRP level was closely related to OSA severity and have potential utility in predicting POAF, duration of hospitalization, and hospital costs in patients undergoing OPCABG.

Keywords: Clinical outcomes; High-sensitivity C-reactive protein; Obstructive sleep apnea; Off-pump cardiac artery bypass grafting.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Flow chart showing the inclusion of patients in this study
Fig. 2
Fig. 2
The Hs-CRP level in the moderate-severe OSA group was significantly higher than that in the no-mild OSA group
Fig. 3
Fig. 3
a The proportion of patients with moderate-severe OSA in the elevated Hs-CRP group was significantly higher than that in the normal Hs-CRP group. b The mean SaO2 in the elevated Hs-CRP group was significantly lower than that in the normal Hs-CRP group
Fig. 4
Fig. 4
a The proportion of patients with POAF in the elevated Hs-CRP group was significantly higher than that in the normal Hs-CRP group. b The duration of hospitalization in the elevated Hs-CRP group was significantly longer than that in normal group. c The hospital cost in the elevated Hs-CRP group was significantly greater than that in the normal Hs-CRP group
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