Central Sleep Apnea in Patients With Coronary Heart Disease Taking P2Y12 Inhibitors.

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  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7902492 Publication Model: Electronic Cited Medium: Internet ISSN: 1533-4023 (Electronic) Linking ISSN: 01602446 NLM ISO Abbreviation: J Cardiovasc Pharmacol Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: New York, Raven Press.
    • Subject Terms:
      Sleep Apnea, Central*/chemically induced ; Sleep Apnea, Central*/diagnosis ; Sleep Apnea, Central*/epidemiology ; Coronary Disease*/diagnosis ; Coronary Disease*/drug therapy ; Coronary Disease*/epidemiology; Humans ; Male ; Middle Aged ; Aged ; Female ; Clopidogrel ; Ticagrelor/adverse effects ; Analgesics, Opioid
    • Abstract:
      Abstract: Central sleep apnea (CSA) is common in patients with heart failure. Recent studies link ticagrelor use with CSA. We aimed to evaluate CSA prevalence in patients with coronary heart disease (CHD) and whether ticagrelor use is associated with CSA. We reviewed consecutive patients with CHD who underwent a polysomnography (PSG) test over a 5-year period from 3 sleep centers. We sampled patients who were on ticagrelor or clopidogrel during a PSG test at a 1:4 ticagrelor:clopidogrel ratio. Patients with an active opioid prescription during PSG test were excluded. Age, left ventricle (LV) dysfunction, and P2Y12 inhibitor use were included in a multivariate logistic regression. A total of 135 patients were included with 26 on ticagrelor and 109 on clopidogrel (age 64.1 ± 11.4, 32% male). High CSA burden (12%) and strict CSA (4.4%) were more common in patients on ticagrelor than in those on clopidogrel (27% vs. 8.3% and 10.0% vs. 1.8%). Ticagrelor use (vs. clopidogrel) was associated with high CSA burden (OR 3.53, 95% CI 1.04-12.9, P = 0.039) and trended toward significance for strict CSA (OR 6.32, 95% CI 1.03-51.4, P = 0.052) when adjusting for age and LV dysfunction. In an additional analysis also adjusting for history of atrial fibrillation, ticagrelor use and strict CSA became significantly associated (OR 10.0, 95% CI 1.32-117, P = 0.035). CSA was uncommon in patients with CHD undergoing sleep studies. Ticagrelor use (vs. clopidogrel) was associated with high CSA burden and trended toward significance for strict CSA.
      Competing Interests: The authors report no conflicts of interest.
      (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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    • Grant Information:
      R01 HL158765 United States HL NHLBI NIH HHS; R21 AG070576 United States AG NIA NIH HHS; R21 HL150502 United States HL NHLBI NIH HHS; R21 HL167126 United States HL NHLBI NIH HHS
    • Accession Number:
      A74586SNO7 (Clopidogrel)
      GLH0314RVC (Ticagrelor)
      0 (Analgesics, Opioid)
    • Publication Date:
      Date Created: 20240105 Date Completed: 20240108 Latest Revision: 20240108
    • Publication Date:
      20240108
    • Accession Number:
      PMC10770467
    • Accession Number:
      10.1097/FJC.0000000000001510
    • Accession Number:
      38180458