Impact of obstructive sleep apnea on the levels of placental growth factor (PlGF) and their value for predicting short-term adverse outcomes in patients with acute coronary syndrome
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Date
2016
Authors
Barceló Bennasar, Antònia
Bauçà, Josep Miquel
Yañez, Aina
Fueyo, Laura
Gomez, Cristina
Peña, Mónica de la
Pierola, Javier
Rodriguez, Alberto
Sánchez de la Torre, Manuel
Abad, Jorge
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Abstract
Background
Placental growth factor (PlGF) induces angiogenesis and promotes tissue repair, and
plasma PlGF levels change markedly during acute myocardial infarction (AMI). Currently,
the impact of obstructive sleep apnea (OSA) in patients with AMI is a subject of debate. Our
objective was to evaluate the relationships between PlGF levels and both the severity of
acute coronary syndrome (ACS) and short-term outcomes after ACS in patients with and
without OSA.
Methods
A total of 538 consecutive patients (312 OSA patients and 226 controls) admitted for ACS
were included in this study. All patients underwent polygraphy in the first 72 hours after hospital
admission. The severity of disease and short-term prognoses were evaluated during
the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence
immunoassay.
Results
Patients with OSA were significantly older and more frequently hypertensive and had higher
BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with
patients without OSA (19.9 pg/mL, interquartile range: 16.6–24.5 pg/mL; 18.5 pg/mL, interquartile
range: 14.7–22.7 pg/mL; p<0.001), and a higher apnea-hypopnea index (AHI) was
associated with higher PlGF concentrations (p<0.003). Patients with higher levels of PlGF
had also an increased odds ratio for the presence of 3 or more diseased vessels and for a
Killip score>1, even after adjustment.
Conclusions
The results of this study show that in patients with ACS, elevated plasma levels of PlGF are
associated with the presence of OSA and with adverse outcomes during short-term followup.
Trial Registration
ClinicalTrials.gov NCT01335087
Citation
Journal or Serie
2016, vol. 11, núm. 3, e0147686