martes, 17 de septiembre de 2013

Sleep disordered breathing as a risk of cardiac... [Am J Cardiol. 2013] - PubMed - NCBI

2013 Apr 15;111(8):1214-20. doi: 10.1016/j.amjcard.2012.12.053. Epub 2013 Feb 12.

Sleep disordered breathing as a risk of cardiac events in subjects with diabetes mellitus and normal exercise echocardiographic findings.

Seicean S, Strohl KP, Seicean A, Gibby C, Marwick TH.

Source

Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.

Abstract

Sleep disordered breathing (SDB) is associated with type 2 diabetes mellitus (T2DM) and cardiovascular disease; however, the contribution of SDB to incident heart failure (HF), coronary artery disease (CAD), and atrial fibrillation (AF) in patients with T2DM is unknown. We followed up 834 consecutive asymptomatic patients with T2DM (age 56 ± 11 years, 369 women) with normal exercise echocardiographic findings for ≤8 years using electronic health records. The demographics, cardiac risk factors, symptoms, diagnoses, and medications were collected at the echocardiography and validated from the electronic health records. SDB was confirmed by a comprehensive sleep evaluation and/or polysomnography before echocardiography. SDB was diagnosed in 188 patients (21%) at baseline; 116 were untreated. During a median follow-up of 4.9 years (interquartile range 3.9 to 6.1), 22 congestive HF, 72 CAD, and 40 AF incident events were observed. In the Cox proportional hazards models, SDB was associated with incident CAD (hazard ratio 1.8, 95% confidence interval 1.1 to 3.0, p = 0.01; adjusted hazard ratio 1.9, 95% confidence interval 1.2 to 3.2, p <0 .01="" 1.1="" 1.2="" 1.4="" 1.5="" 1.9="" 2.2="" 2.6="" 2.7="" 2.9="" 3.3="" 3.5="" 3.9="" 4.7="" 5.9="" 7.0="" 9.0="" 95="" a="" additional="" adjusted="" af="" age="" and="" associated="" association="" asymptomatic="" blood="" cad="" conclusion="" confidence="" correlates="" diagnosed="" elevated="" factor.="" female="" for="" gender="" hazard="" hf="" in="" incident="" interval="" is="" justifies="" left="" liberal="" limiting="" mass="" modifiable="" more="" n="132)," of="" only="" p="" patients="" polysomnography="" potentially="" pressure="" ratio="" realizing="" risk="" screening="" sdb="" t2dm.="" t2dm="" that="" the="" those="" to="" using="" ventricular="" was="" were="" with="">Copyright © 2013 Elsevier Inc. All rights reserved.