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Title: Sleep apnoea and cardiovascular outcomes after coronary artery bypass grafting
Authors: Koo, Chieh Yang 
Aung, Aye-Thandar
Chen, Zhengfeng 
Kristanto, William
Sim, Hui-Wen
Tam, Wilson W 
Gochuico, Carlo F
Tan, Kent Anthony
Kang, Giap-Swee 
Sorokin, Vitaly
Ong, Paul Jau Lueng
Kojodjojo, Pipin 
Richards, Arthur Mark 
Tan, Huay-Cheem 
Kofidis, Theodoros 
Lee, Chi-Hang 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Issue Date: 1-Oct-2020
Citation: Koo, Chieh Yang, Aung, Aye-Thandar, Chen, Zhengfeng, Kristanto, William, Sim, Hui-Wen, Tam, Wilson W, Gochuico, Carlo F, Tan, Kent Anthony, Kang, Giap-Swee, Sorokin, Vitaly, Ong, Paul Jau Lueng, Kojodjojo, Pipin, Richards, Arthur Mark, Tan, Huay-Cheem, Kofidis, Theodoros, Lee, Chi-Hang (2020-10-01). Sleep apnoea and cardiovascular outcomes after coronary artery bypass grafting. HEART 106 (19) : 1495-+. ScholarBank@NUS Repository.
Abstract: Objective Patients with advanced coronary artery disease are referred for coronary artery bypass grafting (CABG) and it remains unknown if sleep apnoea is a risk marker. We evaluated the association between sleep apnoea and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing non-emergent CABG. Methods This was a prospective cohort study conducted between November 2013 and December 2018. Patients from four public hospitals referred to a tertiary cardiac centre for non-emergent CABG were recruited for an overnight sleep study using a wrist-worn Watch-PAT 200 device prior to CABG. Results Among the 1007 patients who completed the study, sleep apnoea (defined as apnoea-hypopnoea index ≥15 events per hour) was diagnosed in 513 patients (50.9%). Over a mean follow-up period of 2.1 years, 124 patients experienced the four-component MACCE (2-year cumulative incidence estimate, 11.3%). There was a total of 33 cardiac deaths (2.5%), 42 non-fatal myocardial infarctions (3.7%), 50 non-fatal strokes (4.9%) and 36 unplanned revascularisations (3.2%). The crude incidence of MACCE was higher in the sleep apnoea group than the non-sleep apnoea group (2-year estimate, 14.7% vs 7.8%; p=0.002). Sleep apnoea predicted the incidence of MACCE in unadjusted Cox regression analysis (HR 1.69; 95% CI 1.18 to 2.43), and remained statistically significant (adjusted HR 1.57; 95% CI 1.09 to 2.25), after adjustment for age, sex, body mass index, left ventricular ejection fraction, diabetes mellitus, hypertension, chronic kidney disease and excessive daytime sleepiness. Conclusion Sleep apnoea is independently associated with increased MACCE in patients undergoing CABG.
Source Title: HEART
ISSN: 13556037
DOI: 10.1136/heartjnl-2019-316118
Appears in Collections:Staff Publications

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