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Title: Excessive daytime sleepiness is associated with longer culprit lesion and adverse outcomes in patients with coronary artery disease
Authors: Lee, C.-H.
Ng, W.-Y. 
Hau, W.
Ho, H.-H.
Tai, B.-C. 
Chan, M.Y.
Richards, A.M.
Tan, H.-C.
Keywords: Coronary artery disease
Intravascular ultrasound
Issue Date: 2013
Source: Lee, C.-H., Ng, W.-Y., Hau, W., Ho, H.-H., Tai, B.-C., Chan, M.Y., Richards, A.M., Tan, H.-C. (2013). Excessive daytime sleepiness is associated with longer culprit lesion and adverse outcomes in patients with coronary artery disease. Journal of Clinical Sleep Medicine 9 (12) : 1267-1272. ScholarBank@NUS Repository.
Abstract: Study Objectives: We assessed whether excessive daytime sleepiness was associated with coronary plaque phenotype and subsequent adverse cardiovascular events. Methods: Prospective cohort study. Intravascular ultrasound (IVUS) examination of the culprit coronary stenosis was performed. The Epworth Sleepiness Scale (ESS) questionnaire was administered, and the patients were divided into 2 groups - (1) sleepier and (2) less sleepy - based on the ESS score. Adverse cardiovascular outcomes were defined as cardiac death, myocardial infarction, stroke, unplanned revascularization, or heart failure admission. Results: One hundred seventeen patients undergoing urgent or non-urgent coronary angiography were recruited. Compared with the less sleepy group (ESS ≤ 10, n = 87), the sleepier group (ESS > 10, n = 30) had higher serum levels of total cholesterol and of low-density-lipoprotein cholesterols (p < 0.05 for both). The IVUS examinations indicated coronary stenoses were longer in the sleepier group than in the less sleepy group (p = 0.011). The cumulative incidence of adverse cardiovascular events at 16-month follow-up was higher in the sleepier than the less sleepy group (12.5% versus 6.9%, p = 0.03). Cox regression analysis adjusting for age and smoking showed increased hazard of adverse cardiovascular events in sleepier group as compared to less sleepy group (HR = 3.44, 95% CI 1.01-11.72). Conclusion: In patients presenting with coronary artery disease, excessive daytime sleepiness based on ESS > 10 was associated with longer culprit lesions and future adverse cardiovascular events.
Source Title: Journal of Clinical Sleep Medicine
ISSN: 15509389
DOI: 10.5664/jcsm.3266
Appears in Collections:Staff Publications

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