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Prevalence of obstructive sleep apnea and changes in sleep duration in patients with coronary insufficiency undergoing percutaneous angioplasty

Grant number: 14/00003-2
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): March 01, 2014
Effective date (End): February 29, 2016
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Luciano Ferreira Drager
Grantee:Matheus Mendonça Péres
Home Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Associated research grant:12/02953-2 - Impact of obstructive sleep apnea and sleep duration on the progression of cardiovascular diseases, AP.JP

Abstract

This research project aims to evaluate the frequency of OSA and changes in sleep duration in patients with established coronary artery disease who are undergoing coronary stenting; Methods Patients During a period of 2 years, we will recruit 300 patients with coronary artery disease with clinical indication for coronary angioplasty with stenting (conventional or pharmacological) in one or more coronary territories. Specifically, we will include patients over 18 who are undergoing percutaneous coronary intervention with success (residual stenosis <20% and TIMI 2-3). We are going to exclude patients with a previous diagnosis of OSA, patients with clinical instability (severe hypotension, heart failure, shock, refractory arrhythmias and conduction disturbances) as well as patients with implantable defibrillators, with limited life expectancy (<1 year), program transplants or transplants and those with inability to give consent to participate in the study. For patients who meet the inclusion criteria and agree to participate in the protocol, we will conduct a clinical evaluation which will include completion of medical records, anthropometric data and filling out questionnaires for assessing risk for OSA (Berlin Questionnaire) and the degree of daytime somnolence ( Epworth Questionnaire) already validated in the Portuguese Language. Sleep Monitoring Polygraphy. For the entire population to be studied, we will perform a portable polygraphy (Embletta) in accordance with the AASM Guidelines. The polygraph consists of a simplified monitoring including airflow by nasal cannula, thoracic and abdominal belts for detection of respiratory movement and oximetry. We will define apnea when there is a reduction of over 90% airflow, observed by nasal cannula, with the presence of respiratory effort verified by abdominal and chest straps. A hypopnea will be defined when there was a 50% reduction in airflow, observed by nasal cannula, associated with arousal or desaturation of 3%. OSA diagnosis will be diagnosed when the apnea and hypopnea index (AHI) will be equal to or greater than 5 events/hour of sleep. Sleep Duration. Sleep duration will be assessed subjectively, with the participant reports the average number of hours of sleep (self-report) and objective manner by placing the actigraphy for 1 week. For each night of actigraphy, the total time in bed as well as the exact time they will begin to try and fall asleep after wake will be collected. The wrist actigraphy has been validated against polysomnography, demonstrating a correlation of more than 0.9 in healthy individuals for the duration of sleep total with the advantage of being performed outside the hospital setting, following the routine of each participant.