Untreated Sleep Apnea increases Long-term Complications after Bypass Surgery – a Study in CHEST May 2015

Obstructive Sleep Apnea is independently associated with a higher rate of long-term cardiovascular events after Coronary Artery Bypass Graft surgery (CHEST May 2015).

Sixty-seven consecutive patients referred for CABG underwent clinical evaluation and standard sleep study in the preoperative period. The primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated angioplasty, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina pain, and heart rhythm disturbances. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) after CABG.

OSA (apnea-hypopnea index ≥ 15 events/h) was present in 56% of the population. The patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. 

In contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up.

OSA was an independent factor associated with the occurrence of MACCE, repeated angioplasty, typical angina, and atrial fibrillation in the multivariate analysis.