• Flavia C Maia, Alessandra C Goulart, Luciano F Drager, Henrique L Staniak, Santos Itamar de Souza IS Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil., Paulo Andrade Lotufo, and Isabela M Bensenor.
• Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil.
• Arq. Bras. Cardiol. 2017 Jan 1; 108 (1): 31-37.

BackgroundObstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography.ObjectiveTo evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate.MethodsBerlin questionnaire, a screening questionnaire for OSA, was applied in 639 cases of ACS 30 days after the index event. Cox regression proportional-hazards model was used to calculate the hazard ratio (HR) of all-cause, cardiovascular and CHD (myocardial infarction) mortality, as well as, the combined endpoint of fatal or recurrent non-fatal CHD.ResultsThe high-risk group for OSA had higher frequencies of previous personal/family history of CHD and diabetes, in addition to a poorer event-free survival, as compared to the low-risk group (p-log-rank=0.03). The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence interval, 1.18 - 15.36) in patients at high risk for OSA compared to those at low risk for OSA after a 2.6-year mean follow-up.ConclusionsUsing Berlin questionnaire, we were able to identify high risk for OSA as an independent predictor of non-fatal reinfarction or CHD mortality in post-ACS individuals in a long-term follow-up.

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