Predictors of obstructive sleep apnoea in patients admitted for acute coronary syndrome
Por:
de Batlle, J, Turino, C, Sanchez-de-la-Torre, A, Abad, J, Duran-Cantolla, J, McEvoy, RD, Antic, NA, Mediano, O, Cabriada, V, Masdeu, MJ, Teran, J, Valls, J, Barbe, F and Sanchez-de-la-Torre, M
Publicada:
1 mar 2017
Resumen:
Identifying undiagnosed obstructive sleep apnoea (OSA) patients in cardiovascular clinics could improve their management. Aiming to build an OSA predictive model, a broad analysis of clinical variables was performed in a cohort of acute coronary syndrome (ACS) patients.
Sociodemographic, anthropometric, life-style and pharmacological variables were recorded. Clinical measures included blood pressure, electrocardiography, echocardiography, blood count, troponin levels and a metabolic panel. OSA was diagnosed using respiratory polygraphy. Logistic regression models and classification and regression trees were used to create predictive models.
A total of 978 patients were included (298 subjects with apnoea-hypopnoea index (AHI) < 15 events.h(-1) and 680 with AHI >= 15 events.h(-1)). Age, BMI, Epworth sleepiness scale, peak troponin levels and use of calcium antagonists were the main determinants of AHI >= 15 events.h(-1) (C statistic 0.71; sensitivity 94%; specificity 24%). Age, BMI, blood triglycerides, peak troponin levels and Killip class >= II were determinants of AHI >= 30 events.h(-1) (C statistic of 0.67; sensitivity 31%; specificity 86%).
Although a set of variables associated with OSA was identified, no model could successfully predict OSA in patients admitted for ACS. Given the high prevalence of OSA, the authors propose respiratory polygraphy as a to-be-explored strategy to identify OSA in ACS patients.
Filiaciones:
de Batlle, J:
Hosp Univ Arnau de Vilanova & Santa Maria, IRBLleida, Resp Dept, Lleida, Spain
Turino, C:
Hosp Univ Arnau de Vilanova & Santa Maria, IRBLleida, Resp Dept, Lleida, Spain
Sanchez-de-la-Torre, A:
Hosp Univ Arnau de Vilanova & Santa Maria, IRBLleida, Resp Dept, Lleida, Spain
Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
:
Hosp Univ Germans Trias i Pujol, Resp Dept, Badalona, Spain
Duran-Cantolla, J:
Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
UPV, OSI Araba Univ Hosp, BioAraba Inst, Dept Med, Vitoria, Spain
McEvoy, RD:
Flinders Univ S Australia, Adelaide Inst Sleep Hlth, Flinders Ctr Res Excellence, Adelaide, SA, Australia
Antic, NA:
Flinders Univ S Australia, Adelaide Inst Sleep Hlth, Flinders Ctr Res Excellence, Adelaide, SA, Australia
Mediano, O:
Hosp Univ Guadalajara, Resp Dept, Guadalajara, Spain
Cabriada, V:
Hosp Cruces, Resp Dept, Bilbao, Spain
Masdeu, MJ:
Hosp Parc Tauli, Resp Dept, Sabadell, Spain
Teran, J:
Hosp Gen Yague, Resp Dept, Burgos, Spain
Valls, J:
IRBLleida, Unit Bioestat & Epidemiol, Lleida, Spain
Barbe, F:
Hosp Univ Arnau de Vilanova & Santa Maria, IRBLleida, Resp Dept, Lleida, Spain
Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
Sanchez-de-la-Torre, M:
Hosp Univ Arnau de Vilanova & Santa Maria, IRBLleida, Resp Dept, Lleida, Spain
Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
Bronze
|