Zusammenfassung
Schlafapnoe hat eine prognostisch ungünstige Bedeutung für Herzpatienten. Wir schlossen 257 konsekutive Patienten mit erhaltener linksventrikulärer Pumpfunktion und angiographisch gesicherter koronarer Herzerkrankung (KHK) in unsere Studie ein. Alle Patienten erhielten eine kardiorespiratorische Polygraphie. Bei 251 Patienten wurde hochsensitives C-reaktives Protein (hsCRP) und Fibrinogen bestimmt. 188 Patienten demonstrierten eine Schlafapnoe (Apnoe-Hypopnoe-Index [AHI] 16,4±1,9/h): 58 Patienten präsentierten eine zentrale (CSA) und 130 Patienten eine obstruktive Schlafapnoe (OSA). Alle Schlafapnoeiker (73 %) zeigten höhere Fibrinogenspiegel als die Patienten ohne Schlafapnoe (p = 0,01). Wir fanden 197 Patienten mit CRP-Werten unter einem cut-off von 0,5 mg/dl (Gruppe 1) und 54 Patienten ohne aktive Infektion, aber mit CRP-Werten >0,5 mg/dl (Gruppe 2). Die Gruppe 2 wies eine deutlich schwerere Schlafapnoe auf (p = 0,01). Schlafapnoe hatte eine hohe Prävalenz bei unseren KHK-Patienten und scheint mit chronischer Inflammation assoziiert zu sein, die wiederum eine Progression der KHK oder akute koronare Ereignisse triggern könnte.
Summary
Sleep-disordered breathing (SDB) has a prognostic impact in patients with cardiac diseases. We included 257 patients with preserved left ventricular function and angiographically proven coronary artery disease (CAD). All patients underwent cardiorespiratory polygraphy. In 251 patients high-sensitive C-reactive protein and fibrinogen were measured. SDB was documented in 188 patients (apnea-hypopnea-index [AHI] 16.4± 1.9/h): 58 patients presented central sleep apnea (CSA) and 130 patients obstructive sleep apnea (OSA). All patients (73%) with SDB had higher blood fibrinogen levels than those without SDB (p = 0.01). We found 197 patients with CRP-values below the cut-off of 0.5 mg/dl (group 1) and 54 patients with no active infection but CRP>0.5 mg/dl (group 2). Severity of SDB was significantly higher in group 2 (p = 0.01). SDB has a high prevalence in CAD patients and seems to be associated with chronic inflammation, which may be linked to CAD progression and/or acute coronary events.
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Prinz, C., Bitter, T., Piper, C. et al. Sleep apnea is common in patients with coronary artery disease. Wien Med Wochenschr 160, 349–355 (2010). https://doi.org/10.1007/s10354-009-0737-x
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DOI: https://doi.org/10.1007/s10354-009-0737-x