Sleep apnoea syndrome and the extent of atherosclerotic lesions in middle-aged men with myocardial infarction

Background. To determine whether extended atherosclerotic lesions are corre lated to the presence of sleep breathing disorders, Methods. Experimental design: A prospective clinical study. Setting: A tert iary regional referral center. Patients: 40 male patients less than or equa l to 65 years consecutively admitted to the cardiac care unit for an acute myocardial infarction with serous creatinine phosphokinase (CPK) greater th an or equal to 350 IU/l and a CPK-MB fraction greater than or equal to 10%, Exclusion criteria were: cardiac surgery on emergency, stroke, major neuro logical and/or psychiatric disturbances, alcohol consumption >50 g/day, tox icomania, clinical or biological hypothyroidism, clinical acromegaly and ch ronic obstructive pulmonary disease. Measures: Duplex ultrasonography was p erformed on carotid arteries, femoral arteries and their bifurcations. An o vernight polysomnography was performed after hospital discharge. Patients w ith an apnoea index > 5/hour or apnoea-hypopnea index > 10/hour of sleep ar e considered to have sleep apnoea syndrome (SAS), Patients with additive pe ripheral atherosclerotic lesions are compared to patients with normal carot id and femoral arteries, regarding to standard cardiovascular risk factors and apnoeas or hypopnoeas during sleep. Results. Duplex revealed in 18 patients carotid and/or femoral atherosclero tic lesions. The prevalence of SAS in patients with at least one peripheral arterial lesion was significantly higher (61% vs 18%,p<0.01). A nearly sig nificant difference was also noted in patients with carotid lesions alone c ompared to those with normal carotid arteries (57% vs 27%, p=0.06). Conclusions. These results suggest a possible link between sleep breathing disorders and the pathogenesis of atherosclerotic lesions.