Key result
Male sex is linked to greater ACS severity in OSA, including ~3% lower LVEF.
Why the study?
The cardiovascular consequences of obstructive sleep apnoea differ by sex, and the influence of sex on the severity of acute coronary syndrome in OSA patients was evaluated.
Does patient sex influence the severity of acute coronary syndrome in patients with newly diagnosed obstructive sleep apnoea?
Observational (n=796)
Open-label
Yes
Does patient sex influence the severity of acute coronary syndrome in patients with newly diagnosed obstructive sleep apnoea?
Absolute Event Rate: 54.54% vs 57.38%
p-value: p=0.002
In patients with obstructive sleep apnoea admitted for acute coronary syndrome, men present with more severe coronary artery disease and lower ejection fraction compared to women.
May warrant sex-specific risk assessment in OSA-ACS; hypothesis-generating and requires prospective validation.
BACKGROUND: The cardiovascular consequences of obstructive sleep apnoea (OSA) differ by sex. We hypothesized that sex influences the severity of acute coronary syndrome (ACS) in patients with OSA. OSA was defined as an apnoea-hypopnoea index (AHI)>15 events·h-1. We evaluated the severity of ACS according to the ejection fraction, Killip class, number of diseased vessels, number of stents implanted and plasma peak troponin level. METHODS: We included 663 men (mean±SD, AHI 37±18 events·h-1) and 133 women (AHI 35±18 events·h-1) with OSA. RESULTS: The men were younger than the women (59±11 versus 66±11 years, p<0.0001), exhibited a higher neck circumference (p<0.0001), and were more likely to be smokers and alcohol users than women (p<0.0001, p = 0.0005, respectively). Body mass index and percentage of hypertensive patients or diabetics were similar between sexes. We observed a slight tendency for a higher Killip classification in women, although it was not statistically significant (p = 0.055). For men, we observed that the number of diseased vessels and the number of stents implanted were higher (p = 0.02, p = 0.001, respectively), and a decrease in the ejection fraction (p = 0.002). CONCLUSIONS: This study shows that sex in OSA influences the severity of ACS. Men show a lower ejection fraction and an increased number of diseased vessels and number of stents implanted.
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Abad et al. (2016) conducted an observational in Obstructive sleep apnoea and acute coronary syndrome (n=796). Male sex vs. Female sex was evaluated on Ejection fraction (%) (p=0.002). In patients with obstructive sleep apnoea admitted for acute coronary syndrome, male sex was associated with greater disease severity compared to female sex, including a lower ejection fraction (54.5% vs 57.4%, p=0.002) and a higher number of implanted stents (1.53 vs 1.19, p=0.001).
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