Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction

Ling-Jie WANG; Li-Na PAN; Ren-Yu YAN; Wei-Wei QUAN; Zhi-Hong XU

doi:10.11909/j.issn.1671-5411.2021.01.002

Journal of Geriatric Cardiology 2021, 18(1): 30-38 https://doi.org/10.11909/j.issn.1671-5411.2021.01.002

Research Article |

Open Access | Issue | Published: 28 January 2021

Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction

Show Author's Information Hide Author's Information Ling-Jie WANG^{¹^,^*}, Li-Na PAN^{²^,^*}, Ren-Yu YAN^², Wei-Wei QUAN^¹(

), Zhi-Hong XU^²(

)

Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

Department of Geriatrics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

^*The authors contributed equally to this manuscript

Cite this article:

WANG L-J, PAN L-N, YAN R-Y, et al. Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction. Journal of Geriatric Cardiology, 2021, 18(1): 30-38. https://doi.org/10.11909/j.issn.1671-5411.2021.01.002

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Abstract Full text Electronic supplementary material About this article

Abstract

OBJECTIVE

Obstructive sleep apnea (OSA) is a potential cardiovascular risk. We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial infarction (AMI).

METHODS

We prospectively enrolled 252 AMI elderly patients (mean age, 68.5 ± 6.9 years) who were undergoing revascularization and completed a sleep study during their hospitalization. All subjects were categorized into non-OSA (apnea–hypopnea index (AHI) < 15, n = 130) and OSA (AHI ≥ 15, n = 122) groups based on the AHI. The changes in the autonomic nervous system, incidence of arrhythmia during nocturnal sleep, and major adverse cardiovascular and cerebrovascular events (MACCEs) were compared between the groups.

RESULTS

The mean AHI value in all AMI patients was 22.8 ± 10.9. OSA patients showed higher levels of body mass index and peak high-sensitivity C-reactive protein and lower levels of minimum nocturnal oxygen saturation (MinSaO₂), as well as greater proportion of multivessel coronary artery disease (all P < 0.05). The OSA group also showed significant increases in heart rate variability and heart rate turbulence onset (both P < 0.05) and higher incidence of arrhythmia (including sinus, atrial, and ventricular in origin). At a median follow-up of 6 months (mean 0.8–1.6 years), OSA (AHI ≥ 15) combined with hypoxia (MinSaO₂ ≤ 80%) was independently associated with the incidence of MACCEs (hazard ratio [HR]: 4.536; 95% confidence interval [CI]: 1.461−14.084, P = 0.009) after adjusting for traditional risk factors.

CONCLUSIONS

OSA and OSA-induced hypoxia may correlate with the severity of myocardial infarction, increase the occurrence of heart rhythm disorders in elderly subacute MI patients, and worsen their short-term poor outcomes.

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About this article

Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction

Show Author's information Hide Author's Information Ling-Jie WANG^{¹^,^*}, Li-Na PAN^{²^,^*}, Ren-Yu YAN^², Wei-Wei QUAN^¹(

), Zhi-Hong XU^²(

)

Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

Department of Geriatrics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

^*The authors contributed equally to this manuscript

Abstract

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS

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Published: 28 January 2021

Issue date: January 2021

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ACKNOWLEDGEMENTS

The authors are grateful to Dr. Feng-Ru ZHANG and Dr. Jia-An HU for their skilled technical assistance. This work was supported by National Natural Science Youth Fund of China (81100098), Shanghai Municipal Commission of Health and Family Planning for Key Discipline Establishment (2015ZB0503 & 201840083), and Production, Teaching and Research Program for University Teachers in Shanghai (RC20190079). The authors declare that they have no conflict of interest.