The Role of Obstructive Sleep Apnea/Hypopnea Syndrome in Stratification of the Cardiovascular Risk in Patients with Non-Valvular Atrial Fibrillation Associated with Ishemic Heart Disease and/or Arterial Hypertension

Objective. To evaluate the role of obstructive sleep apnea-hypopnea syndrome (OSAHS) in stratification of the cardiovascular risk (CVR) by the PROCAM scale in patients with non-valvular atrial fibrillation (AF) associated with ischemic heart disease (IHD) and/or arterial hypertension (AH). Material and methods. 158 patients aged 55.8 ± 8.01 (69.62 % males) with non-valvular AF associated with IHD and/or AH were included into the study. Based on the results of clinical and instrumental data, the study subjects were divided into 4 groups according to presence of OSAHS and the degree of its severity. The total CVR score was calculated by the PROCAM scale in all the patients. Results. In the study subpopulation of the patients with non-valvular AF associated with IHD and/or AH, the frequency rate of OSAHS was 72.78 %. The higher total PROCAM number was more characteristic for the second group of the patients compared to those of the first group (47 (39; 53) vs. 39 (33; 50) respectively; p < 0.01). Occurrence of AH, IHD, chronic heart failure (CHF), diabetes mellitus (DM) and dyslipidemia was higher in moderate and severe OSAHS patients than in non-OSAHS patients (p < 0.01). The strongest positive correlation links were found between the risk values by the PROCAM scale and indices of the apnea/hypopnea and hypoxemia parameters in the patients of the sample group (r = 0.341 and r = 0.289 respectively; р < 0.01). Conclusion. High prevalence of OSAHS in patients with non-valvular AF associated with IHD and/or AH has been revealed. The presence of OSAHS itself and growing severity of the course of this syndrome lead to higher CVR by the evaluation PROCAM scale in patients with non-valvular AF associated with IHD and/or AH. The performed study has confirmed the necessity to introduce the methods of OSAHS verification into practice in AF patients for the purpose of more accurate diagnosis of the present risk and prognosis in patients under examination.

atrial fibrillation, obstructive sleep apnea-hypopnea syndrome, cardiorespiratory monitoring, risk factors, cardiovascular risk assessment, PROCAM scale

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