Yuekun Zhang, Ding Xu, Wen Zheng, Wen Hao, Lei Zhen, Yan Yan, Xiao Wang, Shaoping Nie
{"title":"阻塞性睡眠呼吸暂停和甘油三酯葡萄糖指数对急性冠脉综合征患者心血管事件的影响：OSA-ACS研究的事后分析","authors":"Yuekun Zhang, Ding Xu, Wen Zheng, Wen Hao, Lei Zhen, Yan Yan, Xiao Wang, Shaoping Nie","doi":"10.31083/RCM36205","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is highly prevalent in patients with acute coronary syndrome (ACS). The triglyceride glucose (TyG) index is considered closely linked to cardiovascular risk. However, the relationship between OSA, TyG index, and cardiovascular outcomes in ACS patients remains unclear. Hence, this study aimed to examine the effects of OSA and the TyG index on cardiovascular outcomes in ACS patients.</p><p><strong>Methods: </strong>This post-hoc analysis included 1853 patients from the OSA-ACS project, a single-center prospective cohort study that enrolled ACS patients admitted between January 2015 and December 2019. OSA was defined as an apnea-hypopnea index of ≥15 events/hour. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Multivariable Cox regression models were used to evaluate the impact of OSA on cardiovascular events across the TyG index categories.</p><p><strong>Results: </strong>OSA was present in 52.5% of the participants, with a mean TyG index of 9.02 ± 0.68. Over a median follow-up of 35.1 (19.0-43.5) months, OSA was significantly associated with a heightened risk of MACCE (adjusted hazard ratio (aHR): 1.556; 95% confidence interval (CI): 1.040-2.326; <i>p</i> = 0.031) in the high TyG group within the fully adjusted model, along with elevated risk of hospitalization for unstable angina (aHR: 1.785; 95% CI: 1.072-2.971; <i>p</i> = 0.026). No significant associations were observed between OSA and MACCE in the low and moderate TyG groups.</p><p><strong>Conclusions: </strong>This analysis demonstrates that OSA significantly increases the risk of adverse cardiovascular events in ACS patients with a high TyG index, underscoring the importance of routine OSA screening in these high-risk ACS patients to optimize cardiovascular risk stratification and personalize treatment strategies.</p><p><strong>The clinical trial registration: </strong>NCT03362385, https://clinicaltrials.gov/expert-search?term=NCT03362385.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"36205"},"PeriodicalIF":1.9000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135658/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of Obstructive Sleep Apnea and Triglyceride Glucose Index on Cardiovascular Events in Acute Coronary Syndrome Patients: A Post-Hoc Analysis of the OSA-ACS Study.\",\"authors\":\"Yuekun Zhang, Ding Xu, Wen Zheng, Wen Hao, Lei Zhen, Yan Yan, Xiao Wang, Shaoping Nie\",\"doi\":\"10.31083/RCM36205\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is highly prevalent in patients with acute coronary syndrome (ACS). The triglyceride glucose (TyG) index is considered closely linked to cardiovascular risk. However, the relationship between OSA, TyG index, and cardiovascular outcomes in ACS patients remains unclear. Hence, this study aimed to examine the effects of OSA and the TyG index on cardiovascular outcomes in ACS patients.</p><p><strong>Methods: </strong>This post-hoc analysis included 1853 patients from the OSA-ACS project, a single-center prospective cohort study that enrolled ACS patients admitted between January 2015 and December 2019. OSA was defined as an apnea-hypopnea index of ≥15 events/hour. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Multivariable Cox regression models were used to evaluate the impact of OSA on cardiovascular events across the TyG index categories.</p><p><strong>Results: </strong>OSA was present in 52.5% of the participants, with a mean TyG index of 9.02 ± 0.68. Over a median follow-up of 35.1 (19.0-43.5) months, OSA was significantly associated with a heightened risk of MACCE (adjusted hazard ratio (aHR): 1.556; 95% confidence interval (CI): 1.040-2.326; <i>p</i> = 0.031) in the high TyG group within the fully adjusted model, along with elevated risk of hospitalization for unstable angina (aHR: 1.785; 95% CI: 1.072-2.971; <i>p</i> = 0.026). No significant associations were observed between OSA and MACCE in the low and moderate TyG groups.</p><p><strong>Conclusions: </strong>This analysis demonstrates that OSA significantly increases the risk of adverse cardiovascular events in ACS patients with a high TyG index, underscoring the importance of routine OSA screening in these high-risk ACS patients to optimize cardiovascular risk stratification and personalize treatment strategies.</p><p><strong>The clinical trial registration: </strong>NCT03362385, https://clinicaltrials.gov/expert-search?term=NCT03362385.</p>\",\"PeriodicalId\":20989,\"journal\":{\"name\":\"Reviews in cardiovascular medicine\",\"volume\":\"26 5\",\"pages\":\"36205\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135658/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reviews in cardiovascular medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.31083/RCM36205\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM36205","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Impact of Obstructive Sleep Apnea and Triglyceride Glucose Index on Cardiovascular Events in Acute Coronary Syndrome Patients: A Post-Hoc Analysis of the OSA-ACS Study.
Background: Obstructive sleep apnea (OSA) is highly prevalent in patients with acute coronary syndrome (ACS). The triglyceride glucose (TyG) index is considered closely linked to cardiovascular risk. However, the relationship between OSA, TyG index, and cardiovascular outcomes in ACS patients remains unclear. Hence, this study aimed to examine the effects of OSA and the TyG index on cardiovascular outcomes in ACS patients.
Methods: This post-hoc analysis included 1853 patients from the OSA-ACS project, a single-center prospective cohort study that enrolled ACS patients admitted between January 2015 and December 2019. OSA was defined as an apnea-hypopnea index of ≥15 events/hour. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Multivariable Cox regression models were used to evaluate the impact of OSA on cardiovascular events across the TyG index categories.
Results: OSA was present in 52.5% of the participants, with a mean TyG index of 9.02 ± 0.68. Over a median follow-up of 35.1 (19.0-43.5) months, OSA was significantly associated with a heightened risk of MACCE (adjusted hazard ratio (aHR): 1.556; 95% confidence interval (CI): 1.040-2.326; p = 0.031) in the high TyG group within the fully adjusted model, along with elevated risk of hospitalization for unstable angina (aHR: 1.785; 95% CI: 1.072-2.971; p = 0.026). No significant associations were observed between OSA and MACCE in the low and moderate TyG groups.
Conclusions: This analysis demonstrates that OSA significantly increases the risk of adverse cardiovascular events in ACS patients with a high TyG index, underscoring the importance of routine OSA screening in these high-risk ACS patients to optimize cardiovascular risk stratification and personalize treatment strategies.
The clinical trial registration: NCT03362385, https://clinicaltrials.gov/expert-search?term=NCT03362385.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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