Cardiac arrhythmias and mortality risk among patients with obstructive sleep apnea following admission for acute myocardial infarction or acute ischemic stroke.

Archives of Medical Sciences. Atherosclerotic Diseases Pub Date : 2022-08-10 eCollection Date: 2022-01-01 DOI:10.5114/amsad/150717
Kamleshun Ramphul, Petras Lohana, Renuka Verma, Nomesh Kumar, Yogeshwaree Ramphul, Arti Lohana, Shaheen Sombans, Stephanie Gonzalez Mejias, Komal Kumari
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引用次数: 1

Abstract

Introduction: Obstructive sleep apnea (OSA) can cause several cardiovascular changes that increase the risk of various complications such as acute myocardial infarction (AMI) and acute ischemic stroke (AIS).

Material and methods: We used the 2019 National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP), the Agency for Healthcare Research and Quality (AHRQ), and their many collaborators to study the differences in characteristics and outcomes of OSA patients following AMI or AIS and the presence of several cardiac arrhythmias and their associated mortality risks.

Results: A lower mortality rate was seen among OSA patients with AIS (2.5% compared to 3.8% in non-OSA), and AMI (2.8% compared to 4.7% in non-OSA). OSA patients with AIS had a higher risk of dying if they were aged 66 or over, of Hispanic origin, or if they reported ventricular tachycardia, or paroxysmal atrial fibrillation. For those with OSA and admitted for AMI, they were more at risk of dying if they were aged 66 or over, not classified as "White, Black, or Hispanic", with a history of diabetes, reported ventricular tachycardia, or ventricular fibrillation. Lower adjusted odds ratios were noted among OSA patients with hypertension in both AMI and AIS cases.

Conclusions: Further studies comparing these characteristics based on the severity of OSA are therefore encouraged.

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急性心肌梗死或急性缺血性脑卒中住院后阻塞性睡眠呼吸暂停患者的心律失常和死亡风险
梗阻性睡眠呼吸暂停(OSA)可引起多种心血管变化,增加急性心肌梗死(AMI)和急性缺血性卒中(AIS)等各种并发症的风险。材料和方法:我们使用来自医疗保健成本和利用项目(HCUP)、医疗保健研究和质量机构(AHRQ)及其众多合作者的2019年全国住院患者样本(NIS),研究AMI或AIS后OSA患者的特征和结局差异,以及几种心律失常的存在及其相关的死亡风险。结果:OSA合并AIS患者的死亡率较低(2.5%,非OSA患者为3.8%),AMI患者死亡率较低(2.8%,非OSA患者为4.7%)。OSA合并AIS的患者如果年龄在66岁或以上、西班牙裔、或报告室性心动过速或阵发性心房颤动,死亡风险更高。对于那些患有OSA并因AMI入院的患者,如果他们年龄在66岁或以上,不属于“白人、黑人或西班牙裔”,有糖尿病史,报告室性心动过速或心室颤动,他们死亡的风险更大。在AMI和AIS病例中,OSA合并高血压患者的校正优势比均较低。结论:因此,鼓励基于OSA严重程度比较这些特征的进一步研究。
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