Sleep Apnea and Coronary Artery Disease: Current Concepts

posted Jan 25, 2017, 11:05 PM by sourav ghosh   [ updated Jan 25, 2017, 11:06 PM ]
Rishi Sethi
Professor of Cardiology, KG's Medical University, Lucknow, India

Obstructive sleep apnoea (OSA) is a prevalent but under recognised form of sleep-disorder of breathing and is an emerging risk factor for acute coronary syndrome (ACS). 46–66% of the OSA patients end up with ACS. We sought to determine the effects of ethnicity on the prevalence of OSA which may differ not only between Western and Asian countries, but also within Asia itself.
A pooled analysis using patient-level data from the ISAACC Trial and Sleep and Stent Study was performed. Using the same portable diagnostic device, OSA was defined as an apnoea-hypopnoea index of ≥15 events per hour.
A total of 1961 patients were analysed, including Spanish (n=1050), Chinese (n=500), Indian (n=235), Malay (n=119), Brazilian (n=34) and Burmese (n=23) populations. BMI was significantly different among the various ethnic groups. The prevalence of OSA was highest in the Spanish (63.1%), followed by the Chinese (50.2%), Malay (47.9%), Burmese (43.5%), Brazilian (41.2%), and Indian (36.1%) patients. The estimated odds ratio of BMI on OSA was highest in the Chinese population (1.17; 95% confidence interval: 1.10–1.24). The area under the curve (AUC) for the Asian patients (ranging from 0.6365 to 0.6692) was higher than that for the Spanish patients (0.5161).
There was significant variation in the prevalence of OSA in patients with ACS in different ethnic group. However the effect of BMI onOSA was greater in the Chinese population as compared to other groups.