Impact of OSA on Cardiovascular Events After Coronary Artery Bypass Surgery

Impact of OSA on Cardiovascular Events After Coronary Artery Bypass Surgery

Author Uchoa, Carlos Henrique G. Google Scholar
Danzi-Soares, Naury de Jesus Google Scholar
Nunes, Flavia S. Google Scholar
Souza, Altay A. L. de Autor UNIFESP Google Scholar
Nerbass, Flavia B. Google Scholar
Pedrosa, Rodrigo P. Google Scholar
Cesar, Luiz Antonio M. Google Scholar
Lorenzi-Filho, Geraldo Google Scholar
Drager, Luciano F. Google Scholar
Institution Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Univ Pernambuco
Abstract BACKGROUND: the impact of OSA on new cardiovascular events in patients undergoing coronary artery bypass graft (CABG) surgery is poorly explored.METHODS: Consecutive patients referred for CABG underwent clinical evaluation and standard polysomnography in the preoperative period. CABG surgery data, including percentage of off-pump and on-pump CABG, number of grafts, and intraoperative complications, were collected. the primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated revascularization, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina, and arrhythmias. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) aft er CABG.RESULTS: We studied 67 patients (50 men; mean age, 58 +/- 8 years; mean BMI, 28.5 +/- 4.1 kg/m(2)). OSA (apnea-hypopnea index >= 15 events/h) was present in 56% of the population. the patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. in contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up. OSA was an independent factor associated with the occurrence of MACCE, repeated revascularization, typical angina, and atrial fibrillation in the multivariate analysis.CONCLUSIONS: OSA is independently associated with a higher rate of long-term cardiovascular events aft er CABG and may have prognostic and economic significance in CABG surgery.
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Fundacao Zerbini, Brazil
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number FAPESP: 2012/02953-2
Date 2015-05-01
Published in Chest. Glenview: Amer Coll Chest Physicians, v. 147, n. 5, p. 1352-1360, 2015.
ISSN 0012-3692 (Sherpa/Romeo, impact factor)
Publisher Amer Coll Chest Physicians
Extent 1352-1360
Access rights Closed access
Type Article
Web of Science ID WOS:000354606600040

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