BACKGROUND: While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients. METHODS: We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 h post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (<5 events/h), mild SA (5-15 events/h), moderate SA (15-30 events/h), and severe SA (≥ 30 events/h). RESULTS: Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥ 5 events/h, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6 AM to 12 PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12 AM to 6 AM (all p<0.05). CONCLUSION: There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6 AM and noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.

Department of Internal Medicine and Cardiology University Hospital Brno Czech Republic; Faculty of Medicine Masaryk University Brno Czech Republic

Department of Internal Medicine and Cardiology University Hospital Brno Czech Republic; International Clinical Research Center St Anne's University Hospital Brno Czech Republic; Faculty of Medicine Masaryk University Brno Czech Republic

Division of Cardiovascular Diseases Department of Internal Medicine Mayo Clinic and Foundation Rochester MN USA

Faculty of Medicine Masaryk University Brno Czech Republic

International Clinical Research Center St Anne's University Hospital Brno Czech Republic

International Clinical Research Center St Anne's University Hospital Brno Czech Republic; Department of Cardiovascular Disease St Anne's University Hospital Brno Czech Republic

International Clinical Research Center St Anne's University Hospital Brno Czech Republic; Department of Cardiovascular Disease St Anne's University Hospital Brno Czech Republic; Division of Cardiovascular Diseases Department of Internal Medicine Mayo Clinic and Foundation Rochester MN USA

International Clinical Research Center St Anne's University Hospital Brno Czech Republic; Division of Cardiovascular Diseases Department of Internal Medicine Mayo Clinic and Foundation Rochester MN USA

International Clinical Research Center St Anne's University Hospital Brno Czech Republic; Faculty of Medicine Masaryk University Brno Czech Republic

Int J Cardiol. 2015 May 6;187:486-7. doi: 10.1016/j.ijcard.2015.03.389. PubMed

Int J Cardiol. 2015 Sep 15;195:51-2. doi: 10.1016/j.ijcard.2015.05.051. PubMed

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