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Prevalence of sleep-disordered breathing in acute coronary syndrome: a systemic review and meta-analysis

  • Epidemiology • Original Article
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Abstract

Purpose

This study aimed to review the literature on the prevalence of sleep-disordered breathing (SDB) in patients with acute coronary syndrome (ACS).

Methods

Relevant studies were searched on PubMed, EMBASE, and Cochrane Library through December 2014. Data were extracted using standardized forms. Pooled prevalence of all SDB (apnea-hypopnea index (AHI) > 5), moderate-to-severe SDB (AHI > 15), and severe SDB (AHI > 30) in ACS patients was calculated using DerSimonian-Laird random-effects model. Sensitivity analysis was performed based on races and diagnostic methods of SDB.

Results

A total of 32 studies were included in the present meta-analysis, examining 3360 patients. The meta-analysis indicated that pooled prevalence of all SDB (AHI > 5), moderate-to-severe SDB (AHI > 15), and severe SDB (AHI > 30) in ACS patients were 69 % (95 % confidence interval (CI) = 61, 77 %), 43 % (95 % CI = 36, 49 %), and 25 % (95 % CI = 17, 33 %), respectively. Sensitivity analysis indicated that the pooled prevalence of SDB in Western population was similar to that in Asian population. However, diagnostic methods of SDB seemed to have various impacts on the prevalence of all SDB (AHI > 5), moderate-to-severe SDB (AHI > 15), and severe SDB (AHI > 30).

Conclusions

High prevalence of all SDB, moderate-to-severe SDB, and severe SDB was found in ACS patients. It is clinically important to screen for SDB in patients with ACS.

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Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Zhuoshan Huang

  2. Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tianhe Road, Guangzhou, 510630, China

    Zhengda Zheng, Yanting Luo, Suhua Li, Jieming Zhu & Jinlai Liu

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  1. Zhuoshan Huang
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  2. Zhengda Zheng
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  3. Yanting Luo
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  4. Suhua Li
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  5. Jieming Zhu
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  6. Jinlai Liu
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Correspondence to Jinlai Liu.

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No funding was received for this research.

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The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Comments

This study examined the prevalence of SDB in patients with heart disease showing that it is common and therefore likely to be under diagnosed in patients presenting primarily with heart disease. It can be seen the relationship is present in all populations studied. Given that patients with both SDB and heart disease are predominantly not sleepy the goal of treatment should be outcomes driven which was not examined in this meta-analysis.

Ian Wilcox

NSW, Australia

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Huang, Z., Zheng, Z., Luo, Y. et al. Prevalence of sleep-disordered breathing in acute coronary syndrome: a systemic review and meta-analysis. Sleep Breath 21, 217–226 (2017). https://doi.org/10.1007/s11325-016-1398-9

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  • DOI: https://doi.org/10.1007/s11325-016-1398-9

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