Author + information
- Chieh Yang Koo,
- Luciano Drager,
- Hee-Hwa Ho,
- Thet Hein,
- Man-Hong Jim,
- Mark Chan,
- Mark Richards,
- Huay-Cheem Tan,
- Bee-Choo Tai,
- Junjie Zhang,
- Rishi Sethi and
- Chi-Hang Lee
Background: Obstructive sleep apnea (OSA) predicted major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing percutaneous coronary intervention (PCI) in the multi-center Sleep and Stent Study. In this post-hoc analysis, we determined the relative and combined prognostic impacts of OSA and diabetes mellitus (DM).
Methods: 1311 patients were reclassified into 4 groups based on OSA and DM status. The primary end point was MACCE – a composite of cardiovascular (CV) mortality, non-fatal myocardial infarction, non-fatal stroke and unplanned revascularization. The median follow-up was 1.9 years.
Results: There were 433 OSA(—)DM(—), 323 OSA(+)DM(—), 284 OSA(—)DM(+) and 271 OSA(+)DM(+) patients. The crude cumulative incidence of MACCE (Fig.) was highest in OSA(+)DM(+) (3-year estimate, 22.3%), similar in OSA(+)DM(—) (15.2%) and OSA(—)DM(+) (17.1%), and lowest in OSA(—)DM(—) (11.8%; p<0.001) groups. Likewise, the crude incidence of CV mortality was highest in OSA(+) DM(+) (3-year estimate, 7.4%), but similar in OSA(+)DM(—) (2.7%), OSA(—)DM(+) (1.4%) and OSA(—)DM(—) (1.1%; p=0.002) groups. By Cox regression analysis, OSA(+)DM(+) independently predicted MACCE (adjusted hazard ratio, 2.29; 95% confidence interval, 1.38—3.81; P=0.015) and CV mortality (adjusted subdistribution hazard ratio, 5.59; 95% confidence interval, 1.45—21.56; P=0.018) as compared to OSA(—)DM(—).
Conclusions: OSA and DM exerted a synergistic negative prognostic impact on patients undergoing PCI.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-335
- 2017 American College of Cardiology Foundation