Impact of OSA on Cardiovascular Events After Coronary Artery Bypass Surgery

Author(s)

Uchoa, Carlos Henrique G. ^{[1, 2]} ; Danzi-Soares, Naury de Jesus ^[1] ; Nunes, Flavia S. ^[1] ; de Souza, Altay A. L. ^[3] ; Nerbass, Flavia B. ^[1] ; Pedrosa, Rodrigo P. ^[4] ; Cesar, Luiz Antonio M. ^[5] ; Lorenzi-Filho, Geraldo ^[1] ; Drager, Luciano F. ^{[2, 6, 7]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Div Pulm, Sleep Lab, BR-05403900 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Med, Hypertens Unit, BR-05403900 Sao Paulo - Brazil

^[3] Univ Fed Sao Paulo, Physicobiol Dept, Sao Paulo - Brazil

^[4] Univ Pernambuco, Sleep & Heart Lab, Pronto Socorro Cardiol Pernambuco PROCAPE, Pernambuco - Brazil

^[5] Univ Sao Paulo, Sch Med, Clin Unit Chron Coronary Heart Dis, BR-05403900 Sao Paulo - Brazil

^[6] Univ Sao Paulo, Sch Med, Inst Heart InCor, BR-05403900 Sao Paulo - Brazil

^[7] Univ Sao Paulo, Sch Med, Hypertens Unit, Div Renal, BR-05403900 Sao Paulo - Brazil

• Document type: Journal article
• Source: CHEST; v. 147, n. 5, p. 1352-1360, MAY 2015.
• Web of Science Citations: 37

Abstract

BACKGROUND: The impact of OSA on new cardiovascular events in patients undergoing coronary artery bypass graft (CABG) surgery is poorly explored. METHODS: Consecutive patients referred for CABG underwent clinical evaluation and standard polysomnography in the preoperative period. CABG surgery data, including percentage of off-pump and on-pump CABG, number of grafts, and intraoperative complications, were collected. The primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated revascularization, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina, and arrhythmias. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) aft er CABG. RESULTS: We studied 67 patients (50 men; mean age, 58 +/- 8 years; mean BMI, 28.5 +/- 4.1 kg/m(2)). OSA (apnea-hypopnea index >= 15 events/h) was present in 56% of the population. The patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. In contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up. OSA was an independent factor associated with the occurrence of MACCE, repeated revascularization, typical angina, and atrial fibrillation in the multivariate analysis. CONCLUSIONS: OSA is independently associated with a higher rate of long-term cardiovascular events aft er CABG and may have prognostic and economic significance in CABG surgery. (AU)

• FAPESP's process: 12/02953-2 - Impact of obstructive sleep apnea and sleep duration on the progression of cardiovascular diseases
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Grants - Young Investigators Grants