Effect of CPAP treatment on plasma high sensitivity troponin levels in patients with obstructive sleep apnea

被引:27
作者
Barcelo, Antonia [1 ,5 ]
Esquinas, Cristina [4 ]
Miguel Bauca, Josep [1 ]
Pierola, Javier [3 ,5 ]
de la Pena, Monica [2 ,5 ]
Argue, Meritxell [2 ]
Sanchez-de-la-Torre, Manuel [4 ,5 ]
Alonso-Fernandez, Alberto [2 ,5 ]
Barbe, Ferran [4 ,5 ]
机构
[1] Hosp Univ Son Espases, Serv Anal Clin, Palma De Mallorca 07120, Spain
[2] Hosp Univ Son Espases, Serv Pneumol, Palma De Mallorca 07120, Spain
[3] Hosp Univ Son Espases, Unitat Invest, Palma De Mallorca 07120, Spain
[4] IRB Lleida, Hosp Arnau Vilanova, Serv Pneumol, Lleida, Spain
[5] Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
关键词
Sleep apnea; Troponin; hs-cTnT; CPAP; Sleep disordered breathing; Cardiac biomarker; POSITIVE AIRWAY PRESSURE; CARDIAC TROPONIN; MYOCARDIAL-INFARCTION; DEFINITION;
D O I
10.1016/j.rmed.2014.04.005
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Background: Obstructive sleep apnea (OSA) is associated with an increased prevalence of cardiovascular diseases. New generations of highly sensitive assays for cardiac troponin (hs-cTnT) have been introduced recently, and a number of clinical observations have challenged the notion that troponins are only increased in blood following irreversible necrosis. Objective: The aims of this study were to compare the levels of hs-cTnT between a group of healthy controls and a group of patients with OSA without co-existent coronary artery disease, and to assess the possible influence of the treatment with Continuous positive airway pressure (CPAP) on these levels. Methods: The study population included 200 male participants. The case (n = 133) or control (n = 67) status was defined by an apnea-hypopnea index of 10 or greater. The hs-cTnT assay was validated as reported previously, with a limit of detection of 3 ng/L and an upper reference limit (99th percentile) of 14 ng/L. Results: The proportion of subjects with detectable plasma hs-cTnT was higher in patients with OSA than in controls (61 vs 75%, p = 0.04). In patients, a significant increase in hs-cTnT levels was observed after an effective treatment with CPAP (7.3 +/- 3.4 vs 10.1 +/- 4.9 ng/L; p < 0.01). Conclusion: This study shows that the percentage of subjects with detectable hs-cTnT is associated with the presence of OSA. It also evidences that treatment with CPAP is followed by a rise in hs-cTnT concentrations. It is reasonable to suggest that CPAP therapy might induce a potential degree of cardiac stress, resulting in deleterious consequences for the heart. (C) 2014 Published by Elsevier Ltd.
引用
收藏
页码:1060 / 1063
页数:4
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