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OSACS score-a new simple tool for identifying high risk for Obstructive Sleep Apnea Syndrome based on clinical parameters [Anatol J Cardiol]
Anatol J Cardiol. 2015; 15(1): 50-55 | DOI: 10.5152/akd.2014.5150  

OSACS score-a new simple tool for identifying high risk for Obstructive Sleep Apnea Syndrome based on clinical parameters

Filip M. Szymanski1, Krzysztof J. Filipiak1, Anna E. Platek1, Anna Hrynkiewicz-Szymanska2, Grzegorz Karpinski1, Grzegorz Opolski1
1Department of Cardiology, Medical University of Warsaw-Poland
2Department of Cardiology-Hypertension and Internal Diseases, Medical University of Warsaw-Poland

Objective: Obstructive sleep apnea syndrome (OSAS) is a cardiovascular risk factor associated with clinical complications like hypertension, ischaemic heart disease or thrombosis. The aim of this study was to develop a new scoring system, based on objective clinical and echocardiographic parameters.
 
Methods: One hundred fifty-eight consecutive acute coronary syndrome (ACS) patients underwent standard clinical, laboratory and echocardiography assessment after ACS, and their risk of OSAS was assessed using Berlin Questionnaire and Epworth Sleepiness Scale. Creation of OSACS (Obstructive Sleep Apnea in Acute Coronary Syndrome patients) score was attempted, with risk factors evaluated in multiple logistic regression model.
 
Results: In 34.2% patients, who were at high risk of OSAS left ventricular diastolic diameter, left atrial diameter, and intrventricular septal thickness were elevated. In multiple logistic regression analysis: history of hypertension (Odds Ratio 4.42; 95% CI 0.96-20.5, p=0.06), body mass index (OR 6.82; 95% CI 2.33-20; p<0.001), diastolic blood pressure (OR 6.4; 95% CI 1.58-25.9; p=0.01), left ventricular diastolic diameter (OR 3.5; 95% CI 1.05-11.6; p=0.04), left ventricular mass index (OR 0.26; 95% CI 0.07-0.94; p=0.04), interventricular septal thickness (OR 4.44; 95% CI 1.15-17.1; p=0.03) were independent risk factors for high risk of OSAS. All independent risk factor were implemented into risk prediction model called OSACS. The area under the ROC curve for the OSACS score was 0.87.
 
Conclusion: OSAS is highly prevalent in ACS patients. The new OSACS score has a high predictive value in assessment of risk of OSAS in these patients, and it can be used as an objective tool, and an alternative for the Berlin Questionnaire. 
 

Keywords: acute coronary syndrome, obstructive sleep apnea syndrome, risk stratification


OUAKS skoru - Obstrüktif Uyku Apne Sendromu için yüksek risk belirlenmesinde klinik parametrelere dayalı yeni bir basit araç

Filip M. Szymanski1, Krzysztof J. Filipiak1, Anna E. Platek1, Anna Hrynkiewicz-Szymanska2, Grzegorz Karpinski1, Grzegorz Opolski1
1Department of Cardiology, Medical University of Warsaw-Poland
2Department of Cardiology-Hypertension and Internal Diseases, Medical University of Warsaw-Poland

Amaç: Obstrüktif uyku apne sendromu (OUAS); hipertansiyon, iskemik kalp hastalığı veya tromboz gibi klinik komplikasyonlar ile ilişkili bir kardiyovasküler risk faktörüdür. Bu çalışmanın amacı, objektif klinik ve ekokardiyografik parametrelere dayalı yeni bir skorlama sistemi geliştirmekti.
 
Yöntemler: 158 ardışık akut koroner sendrom (AKS) hastasında AKS sonrası standart klinik, laboratuvar ve ekokardiyografik değerlendirme yapıldı ve OUAS riskleri Berlin Anketi ve Epworth Uyuklama Skalası kullanılarak değerlendirildi. Akut Koroner Sendrom hastalarında Obstrüktif Uyku Apnesi skoru (OUAKS), çoklu lojistik regresyon modelinde değerlendirilen risk faktörleri ile birlikte oluşturulmaya çalışıldı.
 
Bulgular: %34,2 hastada OUAS riski yüksekti. Sol ventrikül diyastol çapı, sol atriyal çap ve interventricular septum kalınlığı artmıştı. Çoklu lojistik regresyon analizinde: hipertansiyon öyküsü (Odds Ratio 4,42; %95 CI 0,96-20,5, p=0,06), vücut kitle indeksi (OR 6,82; %95 CI 2,33-20; p<0,001), diyastolik kan basıncı (OR 6,4; %95 CI 1,58-25,9; p=0,01), sol ventrikül diyastol çapı (OR 3,5; %95 CI 1,05-11,6, p=0,04), sol ventrikül kitle indeksi (OR 0,26; %95 CI 0,07-0,94; p=0,04), interventriküler septum kalınlığı (OR 4,44, %95 CI 1,15-17,1, p=0,03). Yüksek OUAS riski için bağımsız risk faktörleri idi. OUAKS skoru için ROC eğrisi altında kalan alan 0,87 idi.
 
Sonuç: OUAS AKS hastalarında oldukça yaygındır. Yeni OUAKS skoru bu hastalarda OUAS riskinin değerlendirilmesinde yüksek bir prediktif değere sahiptir ve hem objektif bir araç ve hem de Berlin Anketi için bir alternatif olarak kullanılabilir.

Anahtar Kelimeler: Akut koroner sendrom, obstrüktif uyku apne sendromu, risk tabakalandırma.


Filip M. Szymanski, Krzysztof J. Filipiak, Anna E. Platek, Anna Hrynkiewicz-Szymanska, Grzegorz Karpinski, Grzegorz Opolski. OSACS score-a new simple tool for identifying high risk for Obstructive Sleep Apnea Syndrome based on clinical parameters. Anatol J Cardiol. 2015; 15(1): 50-55


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