SLEEP-APNEA AS A RISK MARKER IN CORONARY HEART-DISEASE

Obstructive sleep apnea (OSA) and coronary heart disease (CHD) are bot h frequent in the middle ages. Both diseases share a similar spectrum of risk factors and attendant diseases. The aim of the study was to de termine the prevalence of obstructive sleep apnea in patients with cor onary heart disease diagnosed by coronary angiography Furthermore, inf luence of sleep apnea and attendant diseases and risk factors for coro nary heart disease, especially the risk for myocardial infarction and reduced left ventricular ejection fraction, was investigated. We inclu ded in this study 143 patients (121 men, 22 women, mean age 60 +/- 8 y ears (35-81) who underwent coronary angiography because of angina pect oris or were suspicious for CHD due to noninvasive investigations. The se patients had symptoms of OSA based on a standardized questionnaire. They underwent a four-channel screening with a non-laboratory-monitor ing-system (NLMS) for detection of sleep-related breathing disorders. In addition, spectrum of risk factors and concomitant diseases were co nsidered. Sleep apnea was more frequent in patients with CHD (30.6 %) in comparison to patients without (CHD (21.8 %), but did not reach sta tistical significance. Patients with CHD and OSA had a significantly h igher frequency of a history of myocardial infarction and had a signif icantly lower left ventricular ejection fraction than patients without OSA. In conclusion: Patients with the combination of OSA and CHD are at higher risk for myocardial infarction and reduced left ventricular ejection fraction. Patients with CHD should be screened for OSA in cas e of secondary prevention.