Undiagnosed Sleep Apnea and Bypass OperaTion

Study Overview
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Brief Summary
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Sleep apnea is a prevalent disorder in patients with coronary artery disease. Previous studies suggested sleep apnea was associated with coronary plaque burden and future adverse cardiovascular events after percutaneous coronary intervention. In the SABOT study, the investigators used a FDA-approved portable sleep device to diagnose sleep apnea, and evaluate the relationship between sleep apnea and cardiovascular outcomes after non-urgent coronary artery bypass surgery.

Detailed Description
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The SABOT Study is an observational study designed to study the impact of sleep apnea on cardiovascular outcomes after non-urgent coronary artery bypass surgery (CABG). Patients between the ages of 18 and 90 who are scheduled undergo an non-urgent CABG were eligible for the study The recruited patients participants were scheduled to undergo a hospital-based overnight sleep study using a US Food and Drug Administration-approved portable monitoring devices: the Watch-PAT (Itamar Medical, Caesarea, Israel). Watch-PAT is a four-channel unattended sleep monitoring device that measures peripheral arterial tone (PAT), pulse oximetry, heart rate, and actigraphy from a built-in actigraph. Respiratory events are identified by digital vasoconstriction mediated by α-adrenergic receptors that are sensitive to surges in sympathetic activity. Respiratory events are considered to be present when one of the following three criteria was met: a reduction in PAT amplitude with an acceleration of the pulse rate or an increase in wrist activity; a reduction in PAT amplitude with ≥3% oxyhemoglobin desaturation; and ≥4% oxyhemoglobin desaturation only. Although manual scoring and editing of the Watch-PAT signals are possible, we adopted results generated by the device algorithm alone with no intervention by the operator. The diagnosis of sleep apnea is confirmed if the AHI was greater than 15 events/h. End Points The pre-specified primary end point is a major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke, and repeat revascularization. The secondary end point comprised sudden cardiac death or resuscitated cardiac arrest, all-cause mortality, and hospitalization for heart failure.

Official Title
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Association Between Sleep Apnea and Occurrence of Major Adverse Cardiovascular Events After Coronary Artery Bypass Grafting

Conditions
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Sleep Apnea

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with coronary artery disease scheduled to undergo non-urgent coronary artery bypass surgery Exclusion Criteria: Known sleep apnea on CPAP therapy Cardiogenic shock on mechanical hemodynamic support Intubated on mechanical ventilation Heart failure on oxygen therapy Long -term alpha blocker therapy Severe chronic pulmonary disease Recurrent malignant arrhythmia Inability to provide informed consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sleep apnea group<br>The patients who are found to have sleep apnea based on the results of the portable sleep study | |
| Non sleep apnea group<br>The patients who are found to have no sleep apnea based on the results of the portable sleep study | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major Adverse Cardiac and Cerebrovascular Events | The number of patients with cardiac mortality, stroke, myocardial infarction, or repeat revascularization | Average of 2 years after CABG | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Other Cardiac and Cerebrovascular Events | Sudden cardiac death or resuscitated cardiac arrest, all-cause mortality, hospitalization for heart failure, | Average of 2 years after CABG | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sleep apnea, coronary artery bypass grafting, outcomes