Excessive daytime sleepiness, morning tiredness, and prognostic biomarkers in patients with chronic coronary syndrome.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 Jan 2024
Historique:
received: 07 07 2023
revised: 20 09 2023
accepted: 22 09 2023
medline: 4 12 2023
pubmed: 26 9 2023
entrez: 25 9 2023
Statut: ppublish

Résumé

Sleep-related breathing disorders (SRBD) are related to cardiovascular outcomes in patients with chronic coronary syndrome (CCS). Whether SRBD-related symptoms are associated with prognostic biomarkers in patients with CCS is not established. Associations between frequency (never/rarely, sometimes, often, always) of self-reported SRBD-related symptoms (excessive daytime sleepiness [EDS]; morning tiredness [MT]; loud snoring; multiple awakenings/night; gasping, choking, or apnea when asleep) and levels of biomarkers related to cardiovascular prognosis (high-sensitivity C-reactive protein [hs-CRP], interleukin 6 [IL-6], high-sensitivity cardiac troponin T [hs-cTnT], N-terminal pro B-type natriuretic peptide [NT-proBNP], cystatin C, growth differentiation factor 15 [GDF-15] and lipoprotein-associated phospholipase A EDS was associated (geometric mean ratio, 95% confidence interval) with increased levels of IL-6 (often 1.07 [1.03-1.10], always 1.15 [1.10-1.21]), GDF-15 (often 1.03 [1.01-1.06], always 1.07 [1.03-1.11]), NT-proBNP (always 1.22 [1.12-1.33]), and hs-cTnT (always 1.07 [1.01-1.12]). MT was associated with increased levels of IL-6 (often 1.05 [1.01-1.09], always 1.09 [1.04-1.15]), and GDF-15 (always 1.06 [1.03-1.10]). All symptoms were to some degree associated with higher levels of hs-CRP and loud snoring was also associated with decreased levels of NT-proBNP and hs-cTnT. In patients with CCS, stepwise increased frequency of SRBD-related symptoms, such as EDS and MT, were associated with gradually higher levels of IL-6 and GDF-15, each reflecting distinct pathophysiological pathways.

Sections du résumé

BACKGROUND BACKGROUND
Sleep-related breathing disorders (SRBD) are related to cardiovascular outcomes in patients with chronic coronary syndrome (CCS). Whether SRBD-related symptoms are associated with prognostic biomarkers in patients with CCS is not established.
METHODS METHODS
Associations between frequency (never/rarely, sometimes, often, always) of self-reported SRBD-related symptoms (excessive daytime sleepiness [EDS]; morning tiredness [MT]; loud snoring; multiple awakenings/night; gasping, choking, or apnea when asleep) and levels of biomarkers related to cardiovascular prognosis (high-sensitivity C-reactive protein [hs-CRP], interleukin 6 [IL-6], high-sensitivity cardiac troponin T [hs-cTnT], N-terminal pro B-type natriuretic peptide [NT-proBNP], cystatin C, growth differentiation factor 15 [GDF-15] and lipoprotein-associated phospholipase A
RESULTS RESULTS
EDS was associated (geometric mean ratio, 95% confidence interval) with increased levels of IL-6 (often 1.07 [1.03-1.10], always 1.15 [1.10-1.21]), GDF-15 (often 1.03 [1.01-1.06], always 1.07 [1.03-1.11]), NT-proBNP (always 1.22 [1.12-1.33]), and hs-cTnT (always 1.07 [1.01-1.12]). MT was associated with increased levels of IL-6 (often 1.05 [1.01-1.09], always 1.09 [1.04-1.15]), and GDF-15 (always 1.06 [1.03-1.10]). All symptoms were to some degree associated with higher levels of hs-CRP and loud snoring was also associated with decreased levels of NT-proBNP and hs-cTnT.
CONCLUSIONS CONCLUSIONS
In patients with CCS, stepwise increased frequency of SRBD-related symptoms, such as EDS and MT, were associated with gradually higher levels of IL-6 and GDF-15, each reflecting distinct pathophysiological pathways.

Identifiants

pubmed: 37748524
pii: S0167-5273(23)01388-8
doi: 10.1016/j.ijcard.2023.131395
pii:
doi:

Substances chimiques

C-Reactive Protein 9007-41-4
Growth Differentiation Factor 15 0
Interleukin-6 0
Biomarkers 0
Natriuretic Peptide, Brain 114471-18-0
Peptide Fragments 0
Troponin T 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

131395

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest MO: institutional research grants from GlaxoSmithKline. EH: research grants and speaker fees from Amgen, Sanofi; expert committee fees from NovoNordisk. NH: institutional research grant from GlaxoSmithKline. ML, SD, and AM: no conflict of interest. LW: institutional research grants from AstraZeneca, Bristol-Myers Squibb/Pfizer, GlaxoSmithKline, Merck&Co, Roche Diagnostics, Boehringer Ingelheim; consulting fees from Abbott; holds two patents involving GDF-15, both licensed to Roche Diagnostics. HDW: research grants from GlaxoSmithKline; grants and steering committee fees from Eli Lilly and Company, Omthera Pharmaceuticals, Eisai Inc., Dalcor Pharma UK, American Regent; grants and steering committee and advisory board fees from CSL Behring LLC; grants, steering committee, and personal fees from Sanofi-Aventis Australia Pty Ltd., Esperion Therapeutics Inc., Sanofi-Aventis; advisory board fees from Genentech, Inc.; personal fees from AstraZeneca. RAHS: research grants from GlaxoSmithKline. CH: honoraria from Pfizer; consultant and advisory board fees from AstraZeneca, Bayer, Boehringer Ingelheim.

Auteurs

Maciej Olszowka (M)

Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. Electronic address: maciej.olszowka@medsci.uu.se.

Emil Hagström (E)

Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.

Nermin Hadziosmanovic (N)

Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden.

Mirjam Ljunggren (M)

Department of Medical Sciences, Respiratory-, allergy- and sleep research, Uppsala University, Uppsala, Sweden.

Stefan Denchev (S)

Medical Institute of Ministry of Interior, Sofia, Bulgaria.

Athanasios Manolis (A)

Cardiology Department, Metropolitan Hospital, Athens, Greece.

Lars Wallentin (L)

Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.

Harvey D White (HD)

Green Lane Cardiovascular Service, Te Whatu Ora Health New Zealand, Te Toka Tumai Auckland and University of Auckland, Auckland, New Zealand.

Ralph A H Stewart (RAH)

Green Lane Cardiovascular Service, Te Whatu Ora Health New Zealand, Te Toka Tumai Auckland and University of Auckland, Auckland, New Zealand.

Claes Held (C)

Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.

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Classifications MeSH