Abstract 10706: Severe Sleep Disordered Breathing Lead to Renal Dysfunction in Patients with Acute Coronary Syndrome Underwent Percutaneous Coronary Intervention
Introduction:Recently, the associations between sleep disordered breathing (SDB) and cardiovascular poor outcomes have been reported. It has also been recognized that renal dysfunction in patients with acute coronary syndrome (ACS) is one of the major clinical issues for not only performing percutaneous coronary intervention (PCI) but for predicting the long-term prognosis of those patients. However, the influence of SDB on renal function for ACS patients underwent PCI remains unclear. Hypothesis: We assessed the hypothesis that SDB causes the renal dysfunction in patients with ACS treated by PCI.
Methods: We performed a sleep study in 71 consecutive patients with ACS who were treated by PCI within 24 hours after the admission. We defined severe SDB as apnea hypopnea index> 25/hour. We measured serum creatinine on admission and discharge and then calculated estimated glomerular filtration rate.
Results:Among patients, the rate ofapnea hypopnea index>10, 15, 20, 25/hour were 67.6%, 57.7%, 47.9% and 29.6%, respectively. There were no difference between patients with severe SDB (n=21) and non severe SDB (n=50) in age (68±8 vs 67±13), sex (male 71% vs 76%), coronary risk factors except diabetes, the rate of acute myocardial infarction (71% vs 66%), medications before admission, serum creatinine on admission (0.94±0.20 vs 0.89±0.25mg/dL) and contrast volume during PCI procedure (159±63 vs 145±49mL) (all NS). The body mass index (24.8±4.5 vs 22.1±4.5), diabetes (48% vs 26%) and serum creatinine at discharge (1.07±0.32 vs 0.92±0.23mg/dL) were higher in patients with severe SDB (all p<0.05).Multivariate analysis showed that after adjustment for age, sex, history of hypertension, diabetes, the presence of acute myocardial infarction, hemoglobin level on admission and contrast volume, severe SDB was an independent predictor of renal dysfunction at discharge defined as estimated glomerular filtration rate<60ml/min/1.73m2 (OR 5.19, 95%CI 1.40-19.3, p=0.014).
Conclusion:In patients with ACS performed PCI, there may be clinical association between severe SDB and renal dysfunction at discharge.
- © 2012 by American Heart Association, Inc.