OSA tied to coronary collateral vessel development in STEMI patients

Patients with ST-segment elevation myocardial infarction (STEMI) are more likely to develop a coronary collateral vessel (CCV) in the presence of obstructive sleep apnoea (OSA), according to a study.

A team of investigators prospectively screened 282 STEMI patients with an overnight sleep study to examine the relationship of OSA with CCV development in this population. OSA was defined as apnoea‒hypopnoea index (AHI) ≥15 events/h. Finally, Rentrop grades representing CCVs were assessed using coronary angiograms.

One hundred nineteen STEMI patients met the eligibility criteria, of which 60 had OSA (50.4 percent). CCV development (Rentrop grade ≥2) was substantially more prevalent in STEMI patients with OSA than in those without (43.3 percent vs 5.1 percent; p<0.001).

The investigators observed a parallel increase in the Rentrop grades associated with OSA severity and worsening of hypoxaemia indicators (minimum arterial oxygen saturation [SaO₂], mean SaO₂, and time with SaO₂ <90 percent).

After adjusting for clinical and angiographic characteristics, as well as preprocedure medications that might interact with OSA, AHI as a continuous variable (odds ratio [OR], 1.11, 95 percent confidence interval [CI], 1.08‒1.21; p<0.001) and the presence of OSA (OR, 11.41, 95 percent CI, 2.70‒48.15; p=0.001) remained associated with a significantly higher incidence of CCV development.

“The potential protective effects and mechanisms of OSA in the acute setting of STEMI should be further investigated in larger studies,” the investigators said.