
OSA Linked With Increase in Heart Rhythm Disorder Incidence, Adverse Outcomes
Elderly patients who recently had a heart attack and fit the criteria for obstructive sleep apnea were shown to be at greater risk for heart rhythm disorders, such as arrhythmia and coronary artery disease, as well as for major adverse cardiovascular and cerebrovascular events.
Elderly patients with new-onset acute myocardial infarction (MI) who fit the criteria for obstructive sleep apnea (OSA) were found to be at greater risk for heart rhythm disorders and for major adverse cardiovascular and cerebrovascular events (MACCEs), according to study findings published in
As the
Seeking to further examine this potential relationship in the elderly, who exhibit high prevalence of OSA, poor in-hospital prognosis, and recurrence of acute MI (AMI), researchers prospectively enrolled 252 patients with new-onset AMI who were undergoing
Participants completed a sleep study during their hospitalization where they were then split into 2 groups based on the apnea–hypopnea index (AHI); patients in the non-OSA group (n = 130) had an AHI score of less than 15 and those in the OSA group (n = 122) exhibited an AHI score of 15 or greater.
Researchers assessed the association of OSA with heart rhythm disorders and prognosis in patients with new-onset AMI, with the 2 groups being compared for changes in the autonomic nervous system, incidence of arrhythmia during nocturnal sleep, and MACCEs.
“MACCEs were defined as composite events of cardiovascular death, MI, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.”
Compared with the non-OSA group, patients with OSA presented with significantly higher body mass index (25.8 [3.6] vs 24.1 [3.1] kg/m2 ) and peak
Patients in the OSA group were found to be at greater risk of multi-vessel coronary artery disease, heart rate variability, and heart rate turbulence onset (all P < .05). Notably, occurrence of atrial arrhythmias was nearly 3-fold higher in those with OSA than those without (44.4% vs 16.7%; P < .05), with a higher incidence of sinus and ventricular arrhythmias also reported.
After a median follow-up of 6 months, patients with 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 poor outcomes in the short term,” concluded the study authors.
Reference
Wang LJ, Pan LN, Yan RY, Quan WW, Xu ZH. Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction. J Geriatr Cardiol. Published online January 28, 2021. doi:10.11909/j.issn.1671-5411.2021.01.002
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