P.E. OPOLONSKAYA¹, N.I. MAXIMOV¹, M.Yu. SMETANIN²

¹Izhevsk State Medical Academy, Izhevsk

²Clinical Diagnostic Centre of the Ministry of Healthcare of Udmurt Republic, Izhevsk

 Opolonskaya P.E. ― Assistant of the Department of Hospital Therapy with courses of Cardiology and Functional Diagnostics

Address: 281 Kommunarov Str., Izhevsk, Russian Federation, 426034, e-mail: zareckaya.polina@mail.ru

 Objective ― to study effects of obstructive sleep apnea syndrome (OSAS) on the course of the new ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).

Material and methods. Depending on the presence and severity of OSAS, determined by the oxygen desaturation index (ODI), 130 STEMI patients after PCI with infarct-related artery stenting were divided into three groups: the 1^st group (without OSAS, ODI 0-5/hour); the 2^nd group (mild OSAS, ODI 5-15/hour) and the 3^rd group (medium and severe OSAS, ODI > 15/hour). We used factor analysis to clarify interrelations of indicators that determine OSAS severity with indicators characterizing the development and course of STEMI.

Results and discussion. Protective and training effects of OSAS and nocturnal hypoxemia on the course of STEMI were established according to the main laboratory and instrumental indicators (troponin I (cTnI), impaired left ventricle contractility): in patients with mild OSAS, aggravation of acute and chronic hypoxia was accompanied by a decrease in cTnI ― the «biochemical» level of protection; in patients with moderate and severe OSAS, aggravation of nighttime respiratory disorders was accompanied by preservation of heart contractile function ― the «structural» level of protection.

Conclusion. The results indicate the protective and training effect of OSAS on the course of STEMI.

Key words: STEMI, OSAS, PCI, ODI.

(For citation: Opolonskaya P.E., Maximov N.I., Smetanin M.Yu. Obstructive sleep apnea effect on the course of acute myocardial infarction with ST segment elevation after percutaneous coronary intervention. Practical medicine. 2020. Vol. 18, №1, P. 77-81)

REFERENCES

1. Dewan N.A., Nieto F.J., Somers V.K. Intermittent hypoxemia and OSA: implications for comorbidities. Chest, 2015, 147 (1), pp. 266-274.
2. Berger S., Aronson D., Lavie P., Lavie L. Endothelial progenitor cells in acute myocardial infarction and sleep-disordered breathing. AJRCCM, 2012, 187 (1), pp. 90-98.
3. Rekomendatsiy Vserossiyskogo nauchnogo obshchestva kardiologov “Diagnostika i lechenie bol’nykh ostrym infarktom miokarda s pod»emom segmenta ST EKG” [Recommendations of the All-Russian Scientific Society of Cardiology “Diagnosis and treatment of patients with acute myocardial infarction with a rise in the ST ECG segment”], available at: http://www.scardio.ru/rekomendaci/rekomendacii_rko/nacionalnye_rekomendacii_po_diagnostike_i_lecheniyu_bolnyh_ostrym_infarktom_miokarda_s_podemom_segmenta_st_ekg/ (accessed on: 04.10.2017)
4. Petri A., Sebin K. Naglyadnaya meditsinskaya statistika: ucheb. posobie. 3-e izd., pererab. i dop. [Visual medical statistics: a training manual. 3rd ed., revised. and add.]. Moscow: GEOTAR-Media, 2015. 216 p.
5. Sánchez-de-la-Torre A., Soler X., Barbé F. et al. Cardiac troponin values in patients with acute coronary syndrome and sleep apnea. Chest, 2018, 153 (2), pp. 329-338.
6. Shah N., Redline S., Yaggi H.K., Wu R. et al. Obstructive sleep apnea and acute myocardial infarction severity: ischemic preconditioning? Sleep and Breathing, 2012, 17 (2), pp. 819-826.