Identifying undiagnosed obstructive sleep apnoea (OSA) patients in cardiovascular clinics could improve their management. Aiming to build an OSA predictive model, a broad analysis of clinical variables was performed in a cohort of acute coronary syndrome (ACS) patients.
Sociodemographic, anthropometric, life-style and pharmacological variables were recorded. Clinical measures included blood pressure, electrocardiography, echocardiography, blood count, troponin levels and a metabolic panel. OSA was diagnosed using respiratory polygraphy. Logistic regression models and classification and regression trees were used to create predictive models.
A total of 978 patients were included (298 subjects with apnoea–hypopnoea index (AHI) <15 events·h−1 and 680 with AHI ≥15 events·h−1). Age, BMI, Epworth sleepiness scale, peak troponin levels and use of calcium antagonists were the main determinants of AHI ≥15 events·h−1 (C statistic 0.71; sensitivity 94%; specificity 24%). Age, BMI, blood triglycerides, peak troponin levels and Killip class ≥II were determinants of AHI ≥30 events·h−1 (C statistic of 0.67; sensitivity 31%; specificity 86%).
Although a set of variables associated with OSA was identified, no model could successfully predict OSA in patients admitted for ACS. Given the high prevalence of OSA, the authors propose respiratory polygraphy as a to-be-explored strategy to identify OSA in ACS patients.
Given the high prevalence of OSA in patients suffering ACS, respiratory polygraphy should be routinely performed http://ow.ly/tmKE306wyDc
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Support statement: The study was funded by Aller (Spain), the Catalan Cardiology Society, Esteve-Teijin (Spain), Ministerio de Economía y Competitividad (COFUND2014-51501), the Seventh Framework Programme for Research, technological development and demonstration, Sociedad Española de Neumología y Cirugía Torácica, and Fondo de Investigación Sanitaria, Ministerio de Economía y Competitividad, Una manera de hacer Europa (PI10/02763 and PI10/02745). Funding information for this article has been deposited with the Open Funder Registry.
Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com
- Received March 16, 2016.
- Accepted November 20, 2016.
- Copyright ©ERS 2017