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Association between coronary spastic angina pectoris and obstructive sleep apnea.

Summary of "Association between coronary spastic angina pectoris and obstructive sleep apnea."


BACKGROUND:
Previous studies have shown a higher prevalence of obstructive sleep apnea (OSA) in patients with coronary artery disease than in control subjects. However, the association between coronary spastic angina pectoris (CSA) and OSA has not been investigated. Accordingly, we examined this association. METHODS AND
RESULTS:
We performed overnight polysomnography in 42 consecutive patients with CSA confirmed by an acetylcholine or ergonovine provocation test and in 20 age- and gender-matched control subjects. OSA was classified into the following three groups: mild OSA (5/=30). Patients with CSA had a greater AHI than control subjects (23.4+/-16.3 vs. 10.1+/-8.4, p=0.001), and the prevalence of moderate-to-severe OSA was significantly higher in patients with CSA than in control subjects (66.7% vs. 20%, p=0.001). A multivariate logistic regression analysis showed that moderate-to-severe OSA was independently associated with CSA (odds ratio 9.61, 95% confidence interval 2.11-43.78, p=0.003).
CONCLUSIONS:
The prevalence of moderate-to-severe OSA was significantly higher in patients with CSA than in control subjects, and moderate-to-severe OSA was an independent factor associated with CSA, suggesting that OSA may be one predisposing factor for coronary spasm.

Affiliation

Internal Medicine 2, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu 879-5593, Japan.

Journal Details

This article was published in the following journal.

Name: Journal of cardiology
ISSN: 0914-5087
Pages:

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Medical and Biotech [MESH] Definitions

A condition associated with multiple episodes of sleep apnea which are distinguished from obstructive sleep apnea (SLEEP APNEA, OBSTRUCTIVE) by the complete cessation of efforts to breathe. This disorder is associated with dysfunction of central nervous system centers that regulate respiration. This condition may be idiopathic (primary) or associated with lower brain stem lesions; chronic obstructive pulmonary disease (LUNG DISEASES, OBSTRUCTIVE); HEART FAILURE, CONGESTIVE; medication effect; and other conditions. Sleep maintenance is impaired, resulting in daytime hypersomnolence. Primary central sleep apnea is frequently associated with obstructive sleep apnea. When both forms are present the condition is referred to as mixed sleep apnea (see SLEEP APNEA SYNDROMES). (Adams et al., Principles of Neurology, 6th ed, p395; Neurol Clin 1996;14(3):611-28)

Disorders characterized by multiple cessations of respirations during sleep that induce partial arousals and interfere with the maintenance of sleep. Sleep apnea syndromes are divided into central (see SLEEP APNEA, CENTRAL), obstructive (see SLEEP APNEA, OBSTRUCTIVE), and mixed central-obstructive types.

ANGINA PECTORIS or angina-like chest pain with a normal coronary arteriogram and positive EXERCISE TEST. The cause of the syndrome is unknown. While its recognition is of clinical importance, its prognosis is excellent. (Braunwald, Heart Disease, 4th ed, p1346; Jablonski Dictionary of Syndromes & Eponymic Diseases, 2d ed). It is different from METABOLIC SYNDROME X, a syndrome characterized by INSULIN RESISTANCE and HYPERINSULINEMIA, that has increased risk for cardiovascular disease.

A drug used in the treatment of angina pectoris, heart failure, conduction defects, and myocardial infarction. It is a partial agonist at beta adrenergic receptors and acts as a coronary vasodilator and cardiotonic agent.

The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.

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