Sleep Apnea Clinical Trial
Official title:
Association Between Sleep Apnea and Occurrence of Major Adverse Cardiovascular Events After Coronary Artery Bypass Grafting
Sleep apnea is a prevalent disorder in patients with coronary artery disease. Previous studies suggested sleep apnea was associated with coronary plaque burden and future adverse cardiovascular events after percutaneous coronary intervention. In the SABOT study, the investigators used a FDA-approved portable sleep device to diagnose sleep apnea, and evaluate the relationship between sleep apnea and cardiovascular outcomes after non-urgent coronary artery bypass surgery.
The SABOT Study is an observational study designed to study the impact of sleep apnea on
cardiovascular outcomes after non-urgent coronary artery bypass surgery (CABG). Patients
between the ages of 18 and 90 who are scheduled undergo an non-urgent CABG were eligible for
the study
The recruited patients participants were scheduled to undergo a hospital-based overnight
sleep study using a US Food and Drug Administration-approved portable monitoring devices: the
Watch-PAT (Itamar Medical, Caesarea, Israel). Watch-PAT is a four-channel unattended sleep
monitoring device that measures peripheral arterial tone (PAT), pulse oximetry, heart rate,
and actigraphy from a built-in actigraph. Respiratory events are identified by digital
vasoconstriction mediated by α-adrenergic receptors that are sensitive to surges in
sympathetic activity. Respiratory events are considered to be present when one of the
following three criteria was met: a reduction in PAT amplitude with an acceleration of the
pulse rate or an increase in wrist activity; a reduction in PAT amplitude with ≥3%
oxyhemoglobin desaturation; and ≥4% oxyhemoglobin desaturation only. Although manual scoring
and editing of the Watch-PAT signals are possible, we adopted results generated by the device
algorithm alone with no intervention by the operator. The diagnosis of sleep apnea is
confirmed if the AHI was greater than 15 events/h.
End Points The pre-specified primary end point is a major adverse cardiac and cerebrovascular
event (MACCE), defined as a composite of cardiovascular mortality, non-fatal myocardial
infarction, non-fatal stroke, and repeat revascularization.
The secondary end point comprised sudden cardiac death or resuscitated cardiac arrest,
all-cause mortality, and hospitalization for heart failure.
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