Sleep Apnea Prevalence and Severity after Coronary Revascularization versus no Intervention: A Systematic Review & Meta-analysis

Abstract

Study Objectives : Obstructive sleep apnea (OSA) is a common disease in patients with coronary artery disease (CAD). The manifestation of OSA can vary significantly in different types of CAD patients. This systematic review and meta-analysis compares the prevalence and severity of OSA in acute coronary syndrome (ACS) patients with or without coronary intervention. Methods : The studies in which either coronary artery bypass grafting surgery (CABG), percutaneous coronary intervention (PCI) or no coronary intervention was done on adult patients with ACS were included. As an additional criterion, the study had to include a reliable sleep study after the intervention. The search was conducted 27.1.2023 and all suitable articles after 1.1.2010 were included from four different valid databases. This systematic review followed the PRISMA guidelines. Results: Of the eight included studies, five had performed a sleep study after PCI, two after no coronary intervention and only one study had studied OSA after CABG. Mean AHI in no- OSA group after PCI was 9.6 /h (95% CI 3.6-15.6) and in no intervention group 6.4 /h (95% CI 3.5-9.4). In OSA patients, mean AHI after PCI was 34.9 /h (95% CI 25.9-43.8) vs 24.1 /h without intervention (95% CI 15.6-32.6). Conclusions : Sleep apnea is very common among ACS patients and it is important to take account after intervention. Moreover, we found that OSA is more severe in patients who underwent PCI for ACS than in patients who did not undergo any coronary intervention.