Recurrent acute myocardial infarction and CPAP effect in mild-severe OSA: Is an independent risk factor?

摘要

Identifying and treating obstructive sleep apnea (OSA) may have important implications in the long-term prognosis of patients with post myocardial infarction (Ml). Currently, 42% of the patients admitted with ST-segment elevation myocardial infarction (STEMI) have undiagnosed severe OSA which bears a negative prognostic impact [1 ]. Therefore we read with interest the important study by Garcia-Rio F et al. [2] which analyze the effects of continuous positive airway pressure (CPAP) in patients with OSA and MI. This paper shows a dose-dependent risk of MI at the increase of apnea-hypopnea index (AHI) and less recurrence in those who accept CPAP treatment. However important partner contributing factors could explain these findings.First, authors acknowledge the lack of data on coronary angiography, number of diseased vessels and MI classification, all relevant features for prognosis [3]. A possible selection bias could have occurred on this aspect between compliant and noncompliant patients.