Risk stratification of sudden cardiac death in patients with obstructive sleep apnea syndrome

Introduction The purpose of research is to assess the factors affecting the structural and functional indices of the cardiovascular system and the risk of sudden cardiac death in patients with ischemic heart disease (CHD) and obstructive sleep apnea (OSA).

Materials The study involved 90 patients. Of these, the main group consisted of 61 patients with CHD (exertional angina FC I-II) in combination with OSA, the comparison group consisted of 29 patients with CHD without OSA.

Results In the main group of patients with the syndrome of OSA the prevalence of smoking was found compared to the group without OSA (60% (n = 37) and 42% (n = 12), respectively, with p <0,01 (χ2 = 7.2). During the initial medical contact it was found that patients with CHD combined with OSA had higher values of systolic blood pressure compared with a group of individuals without OSA (SBP) (150 (131-170 ) and 120 (100-140) mm Hg., p <0,05), diastolic blood pressure (DBP) (90 (80-100) and (80 (63,2-90) mm Hg., p <0,05) as well as higher values of heart rate (90 (71-102) and 79 (72-85) min¹ , p <0,05).

In determining the levels of myocardial stress markers a significant increase in homocysteine levels in patients with CHD combined with OSA (38,32 ± 1,04 mmol / l, and 27,18 ± 4,32 mmol / l, respectively, p <0.05) was revealed . Patients with CHD combined with OSA had a significantly higher level of BNP (167,8 ± 9,01 pg / ml, respectively, and 127 ± 7.02 pg / ml, p <0.05).

Conclusions In the presence of OSA and CHD patients have higher values of hypertension and heart rate, as well as the prevalence of smoking. Patients with OSA have an increased LVMI (145 ± 3.6 g / m 2), expressed hyperhomocysteinemia (38,32 ± 1,04 mmol / l), increased levels of BNP (167,8 ± 9,01 pg / ml).