Impact of Obstructive Sleep Apnoea on Clinical Characteristics and Outcomes in Patients with Acute Coronary Syndrome following Percutaneous Coronary Intervention

Abstract
This study tested whether obstructive sleep apnoea syndrome (OSAS) influenced clinical characteristics and outcomes after successful percutaneous coronary intervention (PCI) in 123 consecutive patients with acute coronary syndrome (ACS). Patients with an apnoea–hypopnea index (AHI) ≥ 5 were considered as having OSAS. Carotid ultrasonography and echocardiography were performed, and C-reactive protein (CRP) and fibrinogen were measured. Co-existence of ACS and OSAS occurred in 76 patients (61.8%) and patients with OSAS had a greater interventricular septum thickness (IVST) and higher levels of CRP than non-OSAS patients. In an elderly subpopulation (≥ 75 years of age), two-vessel disease was significantly more common and fibrinogen levels were significantly higher in OSAS than non-OSAS patients. Carotid intima-media thickness (IMT) correlated with the AHI in ACS patients. In elderly ACS patients, IMT, Gensini score and fibrinogen correlated with AHI. Patients were followed up for 1 year for major adverse cardiac events (MACEs) and no significant difference in major MACEs was found after this period between OASAS and non-OSAS patients. This study indicates that OSAS is associated with inflammation and increased IVST in ACS patients after successful PCI and, in elderly ACS patients, also with CAD severity and enhanced blood coagulability.