https://scholars.lib.ntu.edu.tw/handle/123456789/510181
標題: | Timely diagnosis and treatment of sleep apnea reduce cardiovascular sequelae in patients with myocardial infarction | 作者: | Lin M.-T. CHAO LUN LAI PEI-LIN LEE Shen M.-H. CHONG-JEN YU CHI-TAI FANG CHI-LING CHEN |
公開日期: | 2018 | 出版社: | Public Library of Science | 卷: | 13 | 期: | 7 | 起(迄)頁: | e0201493 | 來源出版物: | PLoS ONE | 摘要: | Background The present study aimed to test if the temporal sequence between sleep apnea (SA) diagnosis and incident myocardial infarction (MI) was associated with the long-term mortality and cardiovascular event in a community-based cohort. Methods We retrieved data from 9,453 incident MI patients between Jan. 1st 2000 and Dec. 31st 2012 from the Taiwan National Health Insurance Research Database. The study subjects included 207 MI patients with SA (SA-MI), further stratified into 110 with pre-existing SA before MI (SA-bMI) and 96 diagnosed with SA after MI (SA-pMI). The median follow-up period was 4.2 years. Propensity-score-matched controls were selected from 9,246 non-SA MI patients (non-SA-MI). The association of SA and outcomes including all-cause mortality and major adverse cardiac and cerebrovascular events (MACCEs) were analyzed by a Cox proportional hazards model. Results The result showed that SA was not associated with mortality regardless of the timing of SA diagnosis. SA-pMI was associated with increased risk of MACCEs (Hazard ratio [HR]: 1.412, 95% confidence interval [CI]: 1.037~1.923, p = 0.029) including re-MI or revascularization and ischemic heart disease hospitalization. Such an association was most significant for SA diagnosed within one year after MI (HR: 2.029, 95% CI: 1.265~3.254, p = 0.003), which was not seen in patients treated with continuous positive airway pressure (CPAP). Conclusion The temporal sequence and the time interval between SA diagnosis and incident MI was associated with the cardiovascular events after MI, especially within one year after MI. Early assessment for the presence of SA after incident MI and early CPAP intervention may reduce the risk of further adverse cardiovascular events. ? 2018 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85050879979&doi=10.1371%2fjournal.pone.0201493&partnerID=40&md5=dfd28e6505c67c772ba35763a30ddf8d https://scholars.lib.ntu.edu.tw/handle/123456789/510181 |
ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0201493 | SDG/關鍵字: | adult; aged; all cause mortality; Article; cardiovascular mortality; cardiovascular risk; cerebrovascular disease; clinical outcome; cohort analysis; controlled study; disease association; early diagnosis; early intervention; female; follow up; heart infarction; hospitalization; human; ischemic heart disease; major adverse cardiac event; major clinical study; male; middle aged; positive end expiratory pressure; respiratory tract disease assessment; revascularization; sleep disordered breathing; Taiwan; cardiovascular disease; cause of death; complication; coronary artery disease; early diagnosis; early intervention; epidemiology; heart infarction; heart muscle ischemia; mortality; procedures; retrospective study; sleep disordered breathing; statistics and numerical data; survival analysis; time factor; Aged; Cardiovascular Diseases; Cause of Death; Continuous Positive Airway Pressure; Coronary Artery Disease; Early Diagnosis; Early Medical Intervention; Female; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Retrospective Studies; Sleep Apnea Syndromes; Survival Analysis; Taiwan; Time Factors |
顯示於: | 醫學系 |
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