Skip to main content
Erschienen in: Sleep and Breathing 1/2022

26.03.2021 | Sleep Breathing Physiology and Disorders • Review

Effects of sleep apnea hypopnea syndromes on cardiovascular events: a systematic review and meta-analysis

verfasst von: Liang Xie, Penghao Zhen, Fuchao Yu, Xiaojin Yu, Hai Qian, Fang Yang, Jiayi Tong

Erschienen in: Sleep and Breathing | Ausgabe 1/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Previous studies suggest that sleep apnea hypopnea syndrome (SAHS) is an independent risk factor that contributes to certain cardiovascular events. However, there are studies arguing that patients with SAHS had lower peak troponin levels when suffering cardiovascular events compared to patients without SAHS, which indicates that there may potentially be a protective effect of SAHS. This meta-analysis aimed to assess the impact of SAHS on cardiovascular events.

Methods

Databases were searched for studies that examined cardiac biomarkers or reported angiographic data when patients with SAHS experienced cardiovascular events. The data about peak cardiac biomarkers and angiographic coronary lesion were extracted and then used to compute the pooled standardized mean difference (SMD) and 95% confidence interval (95% CI).

Results

Among 26 studies included in the meta-analysis, there was not a definite difference between the SAHS group and the control group for troponins (SMD, 0.05; 95% CI, [− 0.16, 0.26]), creatine kinase (SMD, − 0.08; 95% CI, [− 0.38, 0.22]), and CK-MB (SMD, − 0.11; 95% CI, [− 0.51, 0.29]). However, patients with SAHS revealed worse coronary lesion condition grading via both Gensini score (SMD, 0.63; 95% CI, [0.31, 0.95]) and SYNTAX score (SMD, 0.99; 95% CI, [0.31–1.67]).

Conclusions

Ischemic preconditioning induced by the intermittent hypoxia at the early stage could generate a cardiac protection effect, which would then benefit SAHS patients encountering a major adverse cardiovascular event.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
3.
Zurück zum Zitat Grote L, Hednera J, Peter JH (2000) Sleep-related breathing disorder is an independent risk factor for uncontrolled hypertension. J Hypertens 18(6):679–685CrossRef Grote L, Hednera J, Peter JH (2000) Sleep-related breathing disorder is an independent risk factor for uncontrolled hypertension. J Hypertens 18(6):679–685CrossRef
5.
Zurück zum Zitat Shamsuzzaman ASM, Gersh BJ, Somers VK (2003) Obstructive sleep apnea: implications for cardiac and vascular disease. J Am Heart Assoc 290(19):1906–1914CrossRef Shamsuzzaman ASM, Gersh BJ, Somers VK (2003) Obstructive sleep apnea: implications for cardiac and vascular disease. J Am Heart Assoc 290(19):1906–1914CrossRef
6.
Zurück zum Zitat Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. NEJM 342(19):1378–1384CrossRef Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. NEJM 342(19):1378–1384CrossRef
7.
Zurück zum Zitat Marshall NS, Wong KKH, Liu PY, Cullen SRJ, Knuiman MW, Grunstein RR (2008) Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 31(8):1079–1085PubMedPubMedCentral Marshall NS, Wong KKH, Liu PY, Cullen SRJ, Knuiman MW, Grunstein RR (2008) Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 31(8):1079–1085PubMedPubMedCentral
8.
Zurück zum Zitat Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto J, Stubbs R, Hla KM (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31(8):1071–1078PubMedPubMedCentral Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto J, Stubbs R, Hla KM (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31(8):1071–1078PubMedPubMedCentral
13.
Zurück zum Zitat Ghofraniha L, Amini M, Davoudi Y, Eslami S, Layegh P, Lotfi Z, Firouzi F, Khajehnasiri S (2017) The relation of carotid arteries’ intima-media thickness with snoring and obstructive sleep apnea in type 2 diabetes patients. Acta Med Iran 55(12):765–771PubMed Ghofraniha L, Amini M, Davoudi Y, Eslami S, Layegh P, Lotfi Z, Firouzi F, Khajehnasiri S (2017) The relation of carotid arteries’ intima-media thickness with snoring and obstructive sleep apnea in type 2 diabetes patients. Acta Med Iran 55(12):765–771PubMed
14.
Zurück zum Zitat Sanchez-de-la-Torre A, Soler X, Barbe F, Flores M, Maisel A, Malhotra A, Rue M, Bertran S, Aldoma A, Worner F, Valls J, Lee CH, Turino C, Galera E, de Batlle J, Sanchez-de-la-Torre M, Spanish Sleep N (2018) Cardiac troponin values in patients with acute coronary syndrome and sleep apnea: a pilot study. Chest 153(2):329–338. https://doi.org/10.1016/j.chest.2017.06.046CrossRefPubMed Sanchez-de-la-Torre A, Soler X, Barbe F, Flores M, Maisel A, Malhotra A, Rue M, Bertran S, Aldoma A, Worner F, Valls J, Lee CH, Turino C, Galera E, de Batlle J, Sanchez-de-la-Torre M, Spanish Sleep N (2018) Cardiac troponin values in patients with acute coronary syndrome and sleep apnea: a pilot study. Chest 153(2):329–338. https://​doi.​org/​10.​1016/​j.​chest.​2017.​06.​046CrossRefPubMed
15.
Zurück zum Zitat Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Ornato JP (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction). J Am Coll Cardiol 44(3):E1–E211. https://doi.org/10.1016/j.jacc.2004.07.014CrossRefPubMed Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Ornato JP (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction). J Am Coll Cardiol 44(3):E1–E211. https://​doi.​org/​10.​1016/​j.​jacc.​2004.​07.​014CrossRefPubMed
16.
Zurück zum Zitat Gensini GG (1983) A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 51:606CrossRef Gensini GG (1983) A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 51:606CrossRef
17.
Zurück zum Zitat Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, van den Brand M, Van Dyck N, Russell ME, Mohr FW, Serruys PW (2005) The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention: Journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 1(2):219-227 Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, van den Brand M, Van Dyck N, Russell ME, Mohr FW, Serruys PW (2005) The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention: Journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 1(2):219-227
18.
Zurück zum Zitat Rostom A, Dube C, Cranney A (2004) Celiac Disease (Evidence Reports/Technology Assessments, No. 104). AHRQ Evidence Reports.Appendix D. Quality Assessment Forms. Appendix D. Quality Assessment Forms Rostom A, Dube C, Cranney A (2004) Celiac Disease (Evidence Reports/Technology Assessments, No. 104). AHRQ Evidence Reports.Appendix D. Quality Assessment Forms. Appendix D. Quality Assessment Forms
19.
Zurück zum Zitat Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, Group P-P (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647. https://doi.org/10.1136/bmj.g7647CrossRef Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, Group P-P (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647. https://​doi.​org/​10.​1136/​bmj.​g7647CrossRef
21.
Zurück zum Zitat Barbe F, Sanchez-de-la-Torre A, Abad J, Duran-Cantolla J, Mediano O, Amilibia J, Masdeu MJ, Flores M, Barcelo A, de la Pena M, Aldoma A, Worner F, Valls J, Castella G, Sanchez-de-la-Torre M, Spanish Sleep N (2015) Effect of obstructive sleep apnoea on severity and short-term prognosis of acute coronary syndrome. Eur Respir J 45(2):419–427. https://doi.org/10.1183/09031936.00071714CrossRefPubMed Barbe F, Sanchez-de-la-Torre A, Abad J, Duran-Cantolla J, Mediano O, Amilibia J, Masdeu MJ, Flores M, Barcelo A, de la Pena M, Aldoma A, Worner F, Valls J, Castella G, Sanchez-de-la-Torre M, Spanish Sleep N (2015) Effect of obstructive sleep apnoea on severity and short-term prognosis of acute coronary syndrome. Eur Respir J 45(2):419–427. https://​doi.​org/​10.​1183/​09031936.​00071714CrossRefPubMed
23.
Zurück zum Zitat Caetano F, Madeira M, Sanches I, Martins V, Almeida I, Moita J, Goncalves L (2015) Obstructive sleep apnoea and coronary artery disease: Does non invasive ventilation have prognostic impact? European Heart Journal: Acute Cardiovascular Care 4:52. https://doi.org/10.1177/2048872615599730 Caetano F, Madeira M, Sanches I, Martins V, Almeida I, Moita J, Goncalves L (2015) Obstructive sleep apnoea and coronary artery disease: Does non invasive ventilation have prognostic impact? European Heart Journal: Acute Cardiovascular Care 4:52. https://​doi.​org/​10.​1177/​2048872615599730​
25.
Zurück zum Zitat Hayashi H, Fukuma N, Kato K, Kato Y, Takahashi H, Mizuno K (2013) Clinical backgrounds and the time course of sleep-disordered breathing in patients after myocardial infarction. J Nippon Med Sch 80(3):192–199CrossRef Hayashi H, Fukuma N, Kato K, Kato Y, Takahashi H, Mizuno K (2013) Clinical backgrounds and the time course of sleep-disordered breathing in patients after myocardial infarction. J Nippon Med Sch 80(3):192–199CrossRef
31.
Zurück zum Zitat Meng S, Fang L, Wang CQ, Wang LS, Chen MT, Huang XH (2009) Impact of obstructive sleep apnoea on clinical characteristics and outcomes in patients with acute coronary syndrome following percutaneous coronary intervention. J Int Med Res 37(5):1343–1353. https://doi.org/10.1177/147323000903700509 Meng S, Fang L, Wang CQ, Wang LS, Chen MT, Huang XH (2009) Impact of obstructive sleep apnoea on clinical characteristics and outcomes in patients with acute coronary syndrome following percutaneous coronary intervention. J Int Med Res 37(5):1343–1353. https://​doi.​org/​10.​1177/​1473230009037005​09
33.
Zurück zum Zitat Long P, Liu J (2014) Obstructive sleep apnea and gensini score in suspected coronary artery disease patients. J Am Coll Cardiol 64(16):C128CrossRef Long P, Liu J (2014) Obstructive sleep apnea and gensini score in suspected coronary artery disease patients. J Am Coll Cardiol 64(16):C128CrossRef
35.
Zurück zum Zitat Furlan S, Uchoa C, Peres M, Freitas L, Mangione F, Lemos P, Lorenzi-Filho G, Drager L (2016) The obstructive sleep apnea is not associated with increased atherosclerotic burden in patients with coronary disease: a preliminary study. J Sleep Res 25:360–361. https://doi.org/10.1111/jsr.12446CrossRef Furlan S, Uchoa C, Peres M, Freitas L, Mangione F, Lemos P, Lorenzi-Filho G, Drager L (2016) The obstructive sleep apnea is not associated with increased atherosclerotic burden in patients with coronary disease: a preliminary study. J Sleep Res 25:360–361. https://​doi.​org/​10.​1111/​jsr.​12446CrossRef
36.
Zurück zum Zitat Ghazal A, Roghani F, Sadeghi M, Amra B, Kermani-Alghoraishi M (2015) Obstructive sleep apnea, diagnosed by the Berlin questionnaire and association with coronary artery disease severity. ARYA Atheroscler 11(5):275–280PubMedPubMedCentral Ghazal A, Roghani F, Sadeghi M, Amra B, Kermani-Alghoraishi M (2015) Obstructive sleep apnea, diagnosed by the Berlin questionnaire and association with coronary artery disease severity. ARYA Atheroscler 11(5):275–280PubMedPubMedCentral
38.
Zurück zum Zitat Kong L, Guo XH (2009) The relation between obstructive sleep apnea hypopnea syndrome and the severity of coronary atherosclerosis in coronary artery Chinese Journal of General. Surgery 48(8):8 Kong L, Guo XH (2009) The relation between obstructive sleep apnea hypopnea syndrome and the severity of coronary atherosclerosis in coronary artery Chinese Journal of General. Surgery 48(8):8
39.
Zurück zum Zitat Wen D, Ying P, Zeng X, Zhang Z, Cardiology DO (2015) The relationship between obstructive sleep apnea syndrome and the severity of coronary artery stenosis. Journal of New Medicine Wen D, Ying P, Zeng X, Zhang Z, Cardiology DO (2015) The relationship between obstructive sleep apnea syndrome and the severity of coronary artery stenosis. Journal of New Medicine
41.
Zurück zum Zitat Lu G, Xu ZW, Liu JN, Zhang YL, Yang ZJ, Zhang XL, Yin KS (2007) [A study on the association of obstructive sleep apnea hypopnea syndrome with coronary atherosclerosis and coronary heart disease]. Zhonghua Jie He He Hu Xi Za Zhi 30(3):178–181 Lu G, Xu ZW, Liu JN, Zhang YL, Yang ZJ, Zhang XL, Yin KS (2007) [A study on the association of obstructive sleep apnea hypopnea syndrome with coronary atherosclerosis and coronary heart disease]. Zhonghua Jie He He Hu Xi Za Zhi 30(3):178–181
42.
Zurück zum Zitat Huang HF, Chen AM, Shen YY, Qian AB, Yun HF, Xiao B, Lv ZL (2016) The characteristics of coronary lesions and influence factors in eldly patients with both coronary artery disease and obstructive sleep apnea syndrome. Electrocardio Circ 35(01):19–21+28 Huang HF, Chen AM, Shen YY, Qian AB, Yun HF, Xiao B, Lv ZL (2016) The characteristics of coronary lesions and influence factors in eldly patients with both coronary artery disease and obstructive sleep apnea syndrome. Electrocardio Circ 35(01):19–21+28
43.
Zurück zum Zitat Calcaianu G, Bresson D, Calcaianu M, Morisset B, El-Nazer T, Deodati C, Virot E, Holtea D, Iamandi C, Debieuvre D (2019) The importance of apneic events in obstructive sleep apnea associated with acute coronary syndrome. Sleep Disord 2019:6039147. https://doi.org/10.1155/2019/6039147 Calcaianu G, Bresson D, Calcaianu M, Morisset B, El-Nazer T, Deodati C, Virot E, Holtea D, Iamandi C, Debieuvre D (2019) The importance of apneic events in obstructive sleep apnea associated with acute coronary syndrome. Sleep Disord 2019:6039147. https://​doi.​org/​10.​1155/​2019/​6039147
48.
Zurück zum Zitat Wan X, Wang WQ, Liu JM, Tong TJ (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14(135):1471–2288 Wan X, Wang WQ, Liu JM, Tong TJ (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14(135):1471–2288
53.
Zurück zum Zitat Tikotekar A, Patel C, Karcnik J, Cheng JQ, Kostis J, Hussain S, Sunderram J (2015) Increased incidence of subendocardial infarcts vs transmural infarcts in OSA: analysis of MIDAS database. Am J Respir Crit Care Med 191 Tikotekar A, Patel C, Karcnik J, Cheng JQ, Kostis J, Hussain S, Sunderram J (2015) Increased incidence of subendocardial infarcts vs transmural infarcts in OSA: analysis of MIDAS database. Am J Respir Crit Care Med 191
57.
Zurück zum Zitat Dong JW, Zhu HF, Zhu WZ, Ding HL, Ma TM, Zhou ZN (2003) Intermittent hypoxia attenuates ischemia/reperfusion induced apoptosis in cardiac myocytes via regulating Bcl-2/Bax expression. Cell Res 13(5):385–391CrossRef Dong JW, Zhu HF, Zhu WZ, Ding HL, Ma TM, Zhou ZN (2003) Intermittent hypoxia attenuates ischemia/reperfusion induced apoptosis in cardiac myocytes via regulating Bcl-2/Bax expression. Cell Res 13(5):385–391CrossRef
Metadaten
Titel
Effects of sleep apnea hypopnea syndromes on cardiovascular events: a systematic review and meta-analysis
verfasst von
Liang Xie
Penghao Zhen
Fuchao Yu
Xiaojin Yu
Hai Qian
Fang Yang
Jiayi Tong
Publikationsdatum
26.03.2021
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 1/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-021-02294-3

Weitere Artikel der Ausgabe 1/2022

Sleep and Breathing 1/2022 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Original Article

Comorbidity clusters in patients with moderate-to-severe OSA

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.