Primary screening of obstructive sleep apnea in patients with acute coronary syndrome


DOI: https://dx.doi.org/10.18565/therapy.2024.6.46-52

Evdokimov D.S., Fizikova A.B., Rukavichnikova A.A., Resnyanskaya E.D.

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg
Abstract. Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder, estimated to affect 17% of female and 34% of male population. At the same time, according to a number of authors, moderate and severe OSAS cases are remaining undiagnosed in approximately 93% of female and 82% of male undividuals.
The aim: to perform primary screening for OSAS in patients with acute coronary syndrome (ACS) using validated questionnaires.
Material and methods. Patients hospitalized for ACS development were included in the study. For primary OSAS screening, STOP-BANG questionnaire, Berlin questionnaire, Epworth sleepiness scale (ESS), test for the presence of obstructive sleep apnea, and a specialized nomogram were used. All the participants were assessed for anthropometric data, medical and life history, and laboratory and instrumental values.
Results. 78 patients were examined – 50 male (64.1%) and 28 female individuals (35.9%) with ACS diagnosis at the moment of hospitalization. When analyzing data on the STOP-BANG scale, 41 (52.6%) of them had a high risk of the disease, average risk degree had 34 (43.6%) patients. According to ESS, 35 (44.9%) of patients had a high risk of OSAS, and 43 (55.1%) of them had a low risk level. Average ESS value in the group was 9.8 ± 4.4 points. According to the screening test for OSAS presence, if there are at least 2 positive answers to 6 questions, the diagnosis of OSAS is highly probable, and such patients should be recommended for further examination at a somnology center. In the studied cohort of patients, there were 43 (55.1%) persons who scored more than 2 points. The average score in the group was 3.7 ± 1.4. Using a specialized nomogram, the risk of moderate/severe OSAS was identified in 30 (38.5%) patients.
Conclusion. Primary screening of OSAS makes it possible to identify a high-risk group among patients having ACS. The members of that group should subsequently be recommended for further examination to verify the diagnosis.
Keywords: primary screening, obstructive sleep apnea syndrome, acute coronary syndrome
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About the Autors

Dmitry S. Evdokimov, MD, assistant at the Department of faculty therapy, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Avenue.
Email: kasabian244@gmail.com
ORCID: https://orcid.org/0000-0002-3107-1691
Aliya B. Fizikova, 4th year student of the Faculty of general medicine, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Avenue.
E-mail: alia_fizikova@mail.ru
ORCID: https://orcid.org/0009-0000-9621-2611
Anastasia A. Rukavichnikova, 4th year student of the Faculty of general medicine, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Avenue.
E-mail: ruk_nast@mail.ru
ORCID: https://orcid.org/0009-0004-7186-898X
Ekaterina D. Resnyanskaya, 5th year student of the Faculty of general medicine, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Avenue.
E-mail: katerina.resn_7@mail.ru
ORCID: https://orcid.org/0000-0001-7889-3679


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