Day-night pattern of acute ST-segment elevation myocardial infarction onset in patients with obstructive sleep apnea.

Obstructive sleep apnea (OSA) is associated with acute nocturnal hemodynamic and neurohormonal abnormalities that may increase the risk of coronary events, especially during the nighttime. This study sought to investigate the day-night pattern of acute ST-segment elevation myocardial infarction (STEMI) onset in patients with OSA and its impact on cardiovascular adverse events. We prospectively enrolled 397 patients with STEMI, for which the time of onset of chest pain was clearly identified. All subjects were categorized into non-OSA (n = 280) and OSA (n = 117) groups. The association between STEMI onset time and major adverse cardiovascular and cerebrovascular events (MACCEs) was estimated by Cox proportional hazards regression. STEMI onset occurred from midnight to 5:59 a.m. in 33% of patients with OSA, as compared with 15% in non-OSA patients ( Patients with OSA exhibited a peak incidence of STEMI between midnight and 5:59 a.m., which showed an independent association with cardiovascular adverse events.

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