TY - JOUR
T1 - Respiratory Polygraphy Patterns and Risk of Recurrent Cardiovascular Events in Patients With Acute Coronary Syndrome
AU - Zapater, Andrea
AU - Solelhac, Geoffroy
AU - Sánchez-de-la-Torre, Alicia
AU - Gracia-Lavedan, Esther
AU - Benitez, Ivan David
AU - Torres, Gerard
AU - De Batlle, Jordi
AU - Haba-Rubio, José
AU - Berger, Mathieu
AU - Abad Capa, Jorge
AU - Duran-Cantolla, Joaquín
AU - Urrutia, Amaia
AU - Mediano, Olga
AU - Masdeu, María José
AU - Ordax-Carbajo, Estrella
AU - Masa, Juan Fernando
AU - De la Peña, Mónica
AU - Mayos, Mercé
AU - Coloma, Ramon
AU - Montserrat, Josep María
AU - Chiner, Eusebi
AU - Mínguez, Olga
AU - Pascual, Lydia
AU - Cortijo, Anunciación
AU - Martínez López, Dolores
AU - Dalmases, Mireia
AU - Lee, Chi-Hang
AU - McEvoy, R. Doug
AU - Barbé, Ferran
AU - Heinzer, Raphael
AU - Sánchez-de-la-Torre, Manuel
PY - 2022
Y1 - 2022
N2 - Obstructive sleep apnea (OSA) severity is based on the apnea-hypopnea index (AHI). The AHI is a simplistic measure that is inadequate for capturing disease severity and its consequences in cardiovascular diseases (CVDs). Deleterious effects of OSA have been suggested to influence the prognosis of specific endotypes of patients with acute coronary syndrome (ACS). We aim to identify respiratory polygraphy (RP) patterns that contribute to identifying the risk of recurrent cardiovascular events in patients with ACS. Post hoc analysis of the ISAACC study, including 723 patients admitted for a first ACS (NCT01335087) in which RP was performed. To identify specific RP patterns, a principal component analysis (PCA) was performed using six RP parameters: AHI, oxygen desaturation index, mean and minimum oxygen saturation (SaO), average duration of events and percentage of time with SaO < 90%. An independent HypnoLaus population-based cohort was used to validate the RP components. From the ISAACC study, PCA showed that two RP components accounted for 70% of the variance in the RP data. These components were validated in the HypnoLaus cohort, with two similar RP components that explained 71.3% of the variance in the RP data. The first component (component 1) was mainly characterized by low mean SaO and obstructive respiratory events with severe desaturation, and the second component (component 2) was characterized by high mean SaO and long-duration obstructive respiratory events without severe desaturation. In the ISAACC cohort, component 2 was associated with an increased risk of recurrent cardiovascular events in the third tertile with an adjusted hazard ratio (95% CI) of 2.44 (1.07 to 5.56; p -value = 0.03) compared to first tertile. For component 1, no significant association was found for the risk of recurrent cardiovascular events. A RP component, mainly characterized by intermittent hypoxemia, is associated with a high risk of recurrent cardiovascular events in patients without previous CVD who have suffered a first ACS.
AB - Obstructive sleep apnea (OSA) severity is based on the apnea-hypopnea index (AHI). The AHI is a simplistic measure that is inadequate for capturing disease severity and its consequences in cardiovascular diseases (CVDs). Deleterious effects of OSA have been suggested to influence the prognosis of specific endotypes of patients with acute coronary syndrome (ACS). We aim to identify respiratory polygraphy (RP) patterns that contribute to identifying the risk of recurrent cardiovascular events in patients with ACS. Post hoc analysis of the ISAACC study, including 723 patients admitted for a first ACS (NCT01335087) in which RP was performed. To identify specific RP patterns, a principal component analysis (PCA) was performed using six RP parameters: AHI, oxygen desaturation index, mean and minimum oxygen saturation (SaO), average duration of events and percentage of time with SaO < 90%. An independent HypnoLaus population-based cohort was used to validate the RP components. From the ISAACC study, PCA showed that two RP components accounted for 70% of the variance in the RP data. These components were validated in the HypnoLaus cohort, with two similar RP components that explained 71.3% of the variance in the RP data. The first component (component 1) was mainly characterized by low mean SaO and obstructive respiratory events with severe desaturation, and the second component (component 2) was characterized by high mean SaO and long-duration obstructive respiratory events without severe desaturation. In the ISAACC cohort, component 2 was associated with an increased risk of recurrent cardiovascular events in the third tertile with an adjusted hazard ratio (95% CI) of 2.44 (1.07 to 5.56; p -value = 0.03) compared to first tertile. For component 1, no significant association was found for the risk of recurrent cardiovascular events. A RP component, mainly characterized by intermittent hypoxemia, is associated with a high risk of recurrent cardiovascular events in patients without previous CVD who have suffered a first ACS.
KW - Acute coronary syndrome
KW - Cardiovascular disease
KW - Obstructive sleep apnea
KW - Precision medicine
KW - Respiratory polygraphy
U2 - 10.3389/fmed.2022.870906
DO - 10.3389/fmed.2022.870906
M3 - Article
C2 - 35833104
SN - 2296-858X
VL - 9
JO - Frontiers in Medicine
JF - Frontiers in Medicine
ER -
