Document Detail


Sleep-disordered breathing and coronary artery disease: long-term prognosis.
MedLine Citation:
PMID:  11734445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The evidence linking sleep-disordered breathing to increased mortality and cardiovascular morbidity has been conflicting and inconclusive. We hypothesized that a potential adverse effect of disordered breathing would be more obvious in patients with established vascular disease. In a prospective cohort study 408 patients aged 70 yr or younger with verified coronary disease were followed for a median period of 5.1 yr. An apnea-hypopnea index (AHI) of > or = 10 and an oxygen desaturation index (ODI) of > or = 5 were used as the diagnostic criteria for sleep-disordered breathing. The primary end point was a composite of death, cerebrovascular events, and myocardial infarction. There was a 70% relative increase and a 10.7% absolute increase in the primary composite end point in patients with disordered breathing defined as an ODI of > or = 5 (risk ratio 1.70, 95% confidence interval [CI] 1.15-2.52, p = 0.008). Similarly, patients with an AHI of > or = 10 had a 62% relative increase and a 10.1% absolute increase in the composite endpoint (risk ratio 1.62, 95% CI 1.09-2.41, p = 0.017). An ODI of > or = 5 and an AHI of > or = 10 were both independently associated with cerebrovascular events (hazard ratio 2.62, 95% CI 1.26-5.46, p = 0.01, and hazard ratio 2.98, 95% CI 1.43-6.20, p = 0.004, respectively). We conclude that sleep-disordered breathing in patients with coronary artery disease is associated with a worse long-term prognosis and has an independent association with cerebrovascular events.
Authors:
T Mooe; K A Franklin; K Holmström; T Rabben; U Wiklund
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  164     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-12-05     Completed Date:  2002-01-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1910-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Umeå University Hospital, Umeå, Sweden. thomas.mooe@medicin.umu.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Gas Analysis
Case-Control Studies
Cause of Death
Cerebrovascular Disorders / epidemiology*,  etiology*
Coronary Angiography
Coronary Disease / complications*,  diagnosis,  mortality*
Female
Humans
Male
Middle Aged
Morbidity
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prospective Studies
Severity of Illness Index
Sleep Apnea Syndromes / classification,  complications*,  diagnosis
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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