Cardiac Troponin Values in Patients with Acute Coronary Syndrome and Sleep Apnea: A Pilot Study.
Chest. 2017 Jul 20;:
Authors: Sánchez-de-la-Torre A, Soler X, Barbé F, Florés M, Maisel A, Malhotra A, Rue M, Bertran S, Aldomá A, Worner F, Valls J, Lee CH, Turino C, Galera E, de Batlle J, Sánchez-de-la-Torre M, Spanish Sleep Group
BACKGROUND: An analysis of cardiac injury markers in patients with obstructive sleep apnea (OSA) who sustain an episode of acute coronary syndrome (ACS) may contribute to a better understanding of the interactions and impact of OSA in ACS subjects. We compared peak cardiac troponin-I (cTn-I) levels in patients admitted for ACS with and without OSA.
METHODS: Blood samples were collected every 6 hours from the time of admission until 2 consecutive assays showed a downward trend in the cTn-I assay. The highest value obtained defined the peak cTn-I value, which provides an estimate of infarct size.
RESULTS: We included 89 OSA and 38 non-OSA patients with an apnea-hypopnea index (AHI) (median [interquartile range (IQR)] of 32 [20.8, 46.6]h(-1) and 4.8 [1.6, 9.6]h(-1), respectively. The peak cTn-I value was significantly higher in non-OSA patients than in OSA patients (median [IQR], 10.7 [1.78, 40.1] vs 3.79 [0.37, 24.3] ng·ml(-1); p=0.04). The multivariable linear regression analysis of the relationship between peak cTn-I value and patient group, age, sex and type of ACS showed that the presence or not of OSA significantly contributed to the peak cTn-I level. The peak cTn-I level was 54% lower in OSA patients than in non-OSA patients.
CONCLUSIONS: The results of this study suggest that OSA has a protective effect in the context of myocardial infarction and that OSA patients may experience less severe myocardial injury. The possible role of OSA in cardioprotection should be explored in future studies.
PMID: 28736306 [PubMed - as supplied by publisher]