Obstructive Sleep Apnea among Individuals Admitted for Myocardial Infarction

  • Ahmad Khajeh-Mehrizi Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Ania Rahimi-Golkhandan Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mojtaba Sedaghat Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Obstructive sleep apnea, Myocardial infarction, Day-night variation


Background and Objective: Obstructive sleep apnea (OSA) is the most common respiratory disorder during sleep and a risk factor for myocardial ischemia. In this study, we evaluated the proportion of subjects at high risk for OSA and prevalence of its predictors among patients admitted for acute myocardial infarction (MI).Materials and Methods: A total of 210 patients with MI admitted at the cardiac care unit of Baharloo Hospital, Tehran, Iran were enrolled in this study. The STOP-BANG questionnaire was used for diagnosing high- risk patients of OSA. Anthropometric and demographic characteristics, family and personal history, results of biochemical tests, and the time of the onset of MI in patients were recorded.Results: Based on the STOP-BANG questionnaire, 112 patients (53.3%) were at high risk for OSA. The lev- el of fasting blood sugar (FBS) was significantly higher in high-risk patients for OSA. Regression analysis showed that FBS could be a predictor of OSA in patients with MI (P value: 0.005). From midnight to 5:59, the frequency of the onset of MI was significantly higher in patients at high risk for OSA compared with those at low risk (42% vs. 16.3%, P <0.001).Conclusions: OSA is a prevalent disorder in patients with MI. Looking for signs and symptoms of OSA should be considered in clinical assessment of MI patients.


Young T, Palta M, Dempsey J, Skatrud J, We- ber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5.

Fletcher EC. Hypertension in patients with sleep apnoea, a combined effect? Thorax 2000;55:726-8.

Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, Topfer V. Sleep-disordered breathing in patients with symptomatic heart failure: a con-temporary study of prevalence in and characteristics of 700 patients. Eur J Heart Fail 2007;9:251-7.

Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-53.

Shahar E, Whitney CW, Redline S, et al. Sleep- disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 2001;163:19-25.

Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circu- lation 2005;112:2660-7.

Jelic S, Padeletti M, Kawut SM, et al. Inflam- mation, oxidative stress, and repair capacity of the vascular endothelium in obstructive sleep apnea. Circulation 2008;117:2270-8.

Lorenzi-Filho G, Drager LF. Obstructive sleep apnea and atherosclerosis: a new paradigm. Am J Respir Crit Care Med 2007;175:1219-21.

Minoguchi K, Yokoe T, Tazaki T, et al. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 175:612-7.

Peker Y, Kraiczi H, Hedner J, Loth S, Johans- son A, Bende M. An independent association be- tween obstructive sleep apnoea and coronary artery disease. Eur Respir J 1999;14:179-84.

Mooe T, Rabben T, Wiklund U, Franklin KA, Eriksson P. Sleep-disordered breathing in men with coronary artery disease. Chest 1996;109:659-63.

Fumagalli S, Tarantini F, Cipriani C, et al. Obstructive sleep apnea after myocardial infarction. Int J Cardiol 2010;145:550-2.

Lee CH, Khoo SM, Tai BC, et al. Obstructive sleep apnea in patients admitted for acute myocardi- al infarction. Prevalence, predictors, and effect on microvascular perfusion. Chest 2009;135:1488-95.

Nakashima H, Katayama T, Takagi C, et al. Obstructive sleep apnoea inhibits the recovery of left ventricular function in patients with acute myocardi- al infarction. Eur Heart J 2006;27:2317-22.

Aboyans V, Cassat C, Lacroix P, et al. Is the morning peak of acute myocardial infarction's onset due to sleep-related breathing disorders? A prospec- tive study. Cardiology 2000;94:188-92.

Ben Ahmed H, Boussaid H, Hamdi I, Boujnah MR. [Prevalence and predictors of obstructive sleep apnea in patients admitted for acute myocardial in-farction]. Ann Cardiol Angeiol (Paris) 2014;63:65-70.

Talaei M, Sarrafzadegan N, Sadeghi M, et al. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Arch Iran Med 2013;16:138-44.

Kohler M, Pepperell JC, Casadei B, et al. CPAP and measures of cardiovascular risk in males with OSAS. Eur Respir J 2008;32:1488-96.

Bloch KE. Polysomnography: a systematic review. Technol Health Care 1997;5:285-305.

Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstruc- tive sleep apnea. Anesthesiology 2008;108:812-21.

Young T, Peppard PE, Gottlieb DJ. Epidemi-ology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002;165:1217-39.

Tasali E, Mokhlesi B, Van Cauter E. Obstruc- tive sleep apnea and type 2 diabetes: interacting epi- demics. Chest 2008;133:496-506.

Kuniyoshi FH, Garcia-Touchard A, Gami AS, et al. Day-night variation of acute myocardial infarc- tion in obstructive sleep apnea. J Am Coll Cardiol 2008;52:343-6.

Gami AS, Howard DE, Olson EJ, Somers VK. Day-night pattern of sudden death in obstruc- tive sleep apnea. N Engl J Med 2005;352:1206-14.

Ludka O, Stepanova R, Vyskocilova M, et al. Sleep apnea prevalence in acute myocardial infarc- tion--the Sleep Apnea in Post-acute Myocardial In-farction Patients (SAPAMI) Study. Int J Cardiol 2014;176:13-9.

How to Cite
Khajeh-Mehrizi A, Rahimi-Golkhandan A, Sedaghat M. Obstructive Sleep Apnea among Individuals Admitted for Myocardial Infarction. JSS. 1(1):23-7.
Original Article(s)