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Cardiac Troponin Values in Patients With Acute Coronary Syndrome and Sleep Apnea: A Pilot Study.

Authors
  • Sánchez-de-la-Torre, Alicia1
  • Soler, Xavier2
  • Barbé, Ferran1
  • Florés, Marina3
  • Maisel, Alan4
  • Malhotra, Atul2
  • Rue, Montserrat5
  • Bertran, Sandra5
  • Aldomá, Albina6
  • Worner, Fernando6
  • Valls, Joan5
  • Lee, Chi-Hang7
  • Turino, Cecilia1
  • Galera, Estefanía3
  • de Batlle, Jordi1
  • Sánchez-de-la-Torre, Manuel8
  • 1 Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida. Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. , (Spain)
  • 2 Pulmonary Division, Department of Critical Care and Sleep Medicine, UC San Diego, San Diego, CA.
  • 3 Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida. Lleida, Catalonia, Spain. , (Spain)
  • 4 Cardiology Division, Veterans Affairs Medical Center, San Diego, CA.
  • 5 Department of Basic Medical Sciences, IRBLleida - University of Lleida. Lleida, Catalonia, Spain. , (Spain)
  • 6 Cardiology Department, Hospital Universitari Arnau de Vilanova, IRBLleida. Lleida, Catalonia, Spain. , (Spain)
  • 7 Department of Cardiology, National University Heart Centre, Singapore. , (Singapore)
  • 8 Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida. Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. Electronic address: [email protected] , (Spain)
Type
Published Article
Journal
CHEST Journal
Publisher
Elsevier
Publication Date
Feb 01, 2018
Volume
153
Issue
2
Pages
329–338
Identifiers
DOI: 10.1016/j.chest.2017.06.046
PMID: 28736306
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

An analysis of cardiac injury markers in patients with OSA who sustain an episode of acute coronary syndrome (ACS) may contribute to a better understanding of the interactions and impact of OSA in subjects with ACS. We compared peak cardiac troponin I (cTnI) levels in patients with OSA and patients without OSA who were admitted for ACS. Blood samples were collected every 6 hours from the time of admission until two consecutive assays showed a downward trend in the cTnI assay. The highest value obtained defined the peak cTnI value, which provides an estimate of infarct size. We included 89 patients with OSA and 38 patients without OSA with an apnea-hypopnea index of a median of 32 (interquartile range [IQR], 20.8-46.6/h and 4.8 [IQR, 1.6-9.6]/h, respectively. The peak cTnI value was significantly higher in patients without OSA than in patients with OSA (median, 10.7 ng/mL [IQR, 1.78-40.1 ng/mL] vs 3.79 ng/mL [IQR, 0.37-24.3 ng/mL]; P = .04). The multivariable linear regression analysis of the relationship between peak cTnI value and patient group, age, sex, and type of ACS showed that the presence or absence of OSA significantly contributed to the peak cTnI level, which was 54% lower in patients with OSA than in those without OSA. The results of this study suggest that OSA has a protective effect in the context of myocardial infarction and that patients with OSA may experience less severe myocardial injury. The possible role of OSA in cardioprotection should be explored in future studies. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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