Dataset Information

Sleep disorders and increased risk of subsequent acute coronary syndrome in individuals without sleep apnea: a nationwide population-based cohort study.

ABSTRACT:

Objectives

Studies investigating the relationship between nonapnea sleep disorders and the risk of acute coronary syndrome (ACS) are scant. This study evaluated whether the risk of ACS is associated with sleep disorders other than sleep apnea in Taiwan.

Methods

This longitudinal nationwide population-based cohort study investigated the incidence and risk of ACS in 49,099 cases of nonapnea sleep disorders newly diagnosed from January 1997 to December 2001. In total, 98,198 control participants without sleep disorders were randomly selected, frequency matched by age and sex from the general population. The follow-up period started from the date of entering the study cohort to the date of an ACS event, censoring, or December 31, 2010. We conducted Cox proportional hazard regression analysis to estimate the effects of nonapnea sleep disorders on ACS risk.

Results

The nonapnea sleep disorder cohort had an adjusted hazard ratio (HR; 95% confidence interval [CI] = 1.29-1.60) of subsequent ACS 1.43-fold higher than that of the cohort without sleep disorders. The highest crude effect of nonapnea sleep disorders on ACS incidence was detected among young adults. However, by adjusting for probable risk factors, the HR of ACS increased with age. Compared with women, men had an adjusted HR of 1.57 (95% CI = 1.42-1.75). Hypertension, diabetes mellitus (DM), and hyperlipidemia were also significant factors associated with the increased risk of ACS.

Conclusion

This nationwide population-based cohort study provides evidence that patients with nonapnea sleep disorders are at higher risk of developing acute coronary syndrome, which increases with age.

SUBMITTER: Chung WS

PROVIDER: S-EPMC3825447 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Publications

Sleep disorders and increased risk of subsequent acute coronary syndrome in individuals without sleep apnea: a nationwide population-based cohort study.

Chung Wei-Sheng WS Lin Cheng-Li CL Chen Yung-Fu YF Chiang John Y JY Sung Fung-Chang FC Chang Yen-Jung YJ Kao Chia-Hung CH

Sleep 20131201 12

<h4>Objectives</h4>Studies investigating the relationship between nonapnea sleep disorders and the risk of acute coronary syndrome (ACS) are scant. This study evaluated whether the risk of ACS is associated with sleep disorders other than sleep apnea in Taiwan.<h4>Methods</h4>This longitudinal nationwide population-based cohort study investigated the incidence and risk of ACS in 49,099 cases of nonapnea sleep disorders newly diagnosed from January 1997 to December 2001. In total, 98,198 control ...[more]

PMID: 24293772

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Project description:Children with craniofacial disorders are at increased risk for obstructive sleep apnea syndrome. Methods for diagnosing obstructive sleep apnea syndrome in this population remain controversial. Sleep studies are the criterion standard but are impractical for all patients. The utility of obstructive sleep apnea syndrome questionnaires such as the Pediatric Sleep Questionnaire is unknown in children with craniofacial disorders. The authors hypothesized that the Pediatric Sleep Questionnaire would be a sensitive tool for detecting obstructive sleep apnea syndrome in children with craniofacial abnormalities.A retrospective review of consecutive children with diagnosed craniofacial disorders who both completed the Pediatric Sleep Questionnaire and underwent polysomnography was performed. Demographics, Pediatric Sleep Questionnaire score, and polysomnographic data were recorded. Statistical analysis included calculation of sensitivity, specificity, positive predictive value, and negative predictive value for the Pediatric Sleep Questionnaire.Eighty-three children aged 2 to 18 years were included in the study. Of these, 44 (53.0 percent) screened positive on the Pediatric Sleep Questionnaire and 23 (27.7 percent) had polysomnographic evidence of obstructive sleep apnea syndrome, but the sensitivity of the Pediatric Sleep Questionnaire for detecting obstructive sleep apnea syndrome in this sample was only 0.57 and the specificity was 0.48. Positive predictive value and negative predictive value were 0.30 and 0.74, respectively. The correlation between the apnea hypopnea index and Pediatric Sleep Questionnaire score was 0.152 (p = 0.17).A substantial portion of craniofacial patients referred for polysomnography was found to have obstructive sleep apnea syndrome. However, the Pediatric Sleep Questionnaire is not a good screening tool for obstructive sleep apnea syndrome in children with craniofacial conditions. More research is needed to determine which patients with craniofacial disorders should be evaluated for obstructive sleep apnea syndrome by polysomnography or other means.Diagnostic, II.

Project description:Background The aim of this prospective study was to determine the impact of elevated ANGPTL3 (angiopoietin-like protein 3) on cardiovascular events (CVEs) following acute coronary syndrome (ACS) in patients with or without obstructive sleep apnea (OSA). Methods and Results A total of 1174 patients with ACS underwent successful percutaneous coronary intervention were included in this prospective cohort study (NCT03362385). Patients were categorized according to the apnea-hypopnea index (≥15 events/h, OSA) and further classified by ANGPTL3 levels. We analyzed the incidence of CVEs in patients with ACS according to the status of OSA and ANGPTL3. During a median of 3.1 years of follow-up, 217 (18.48%) CVEs occurred. The patients with ACS with OSA had higher ANGPTL3 levels than those without OSA (30.4 [20.9-43.2] versus 27.80 [19.1-41.5] ng/mL; P<0.001). In all patients with ACS, 29≤ANGPTL3<42 mg/dL and ANGPTL3≥42 mg/dL were associated with an increased risk of CVEs with hazard ratios (HRs) of 1.555 (95% CI, 1.010-2.498) and 2.489 (95% CI 1.613-3.840), respectively. When the status of OSA or not was incorporated in stratifying factors, 29≤ANGPTL3<42 mg/dL and ANGPTL3≥42 mg/dL were associated with a significantly higher risk of CVEs in patients with ACS with OSA (HR, 1.916 [95% CI, 1.019-3.601] and HR, 2.692 [95% CI, 1.379-4.503]) but not without OSA. Moreover, adding ANGPTL3 to the Cox model increased C-statistic values by 0.035 and 0.029 in the OSA group and all patients with ACS, respectively, but was not statistically improved in patients with ACS without OSA. Conclusions In conclusion, our study demonstrates a predictive impact of plasma ANGPTL3 on cardiovascular risk in patients with ACS, especially in patients with ACS with OSA. It might be of clinical value in refining risk stratification and tailoring treatment of patients with ACS and OSA. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03362385.

Dataset Information

Sleep disorders and increased risk of subsequent acute coronary syndrome in individuals without sleep apnea: a nationwide population-based cohort study.

Objectives

Methods

Results

Conclusion

Publications

Sleep disorders and increased risk of subsequent acute coronary syndrome in individuals without sleep apnea: a nationwide population-based cohort study.

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