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

Antonia Barcelo, Josep Miquel Bauça, Aina Yañez, Laura Fueyo, Cristina Gomez, Monica de la Peña, Javier Pierola, Alberto Rodriguez, Manuel Sanchez-de-la-Torre, Jorge Abad, Olga Mediano, Jose Amilibia, Maria Jose Masdeu, Joaquin Teran, Josep Maria Montserrat, Mercè Mayos, Alicia Sanchez-de-la-Torre, Ferran Barbé, Spanish Sleep Group, Amanda López-Picado, Erika Miranda-Serrano, Cristina Martinez-Null, Ramón Rubio, Maria Luz Alonso, José Cordero, Cristobal Esteban, Antonio Jiménez, Maria Rosario Carpizo, Gabriel Sanpol, Jaime Corral, Manola Rubio, Antonia Barceló, Javier Piérola, José María Marín, Antonia Barcelo, Josep Miquel Bauça, Aina Yañez, Laura Fueyo, Cristina Gomez, Monica de la Peña, Javier Pierola, Alberto Rodriguez, Manuel Sanchez-de-la-Torre, Jorge Abad, Olga Mediano, Jose Amilibia, Maria Jose Masdeu, Joaquin Teran, Josep Maria Montserrat, Mercè Mayos, Alicia Sanchez-de-la-Torre, Ferran Barbé, Spanish Sleep Group, Amanda López-Picado, Erika Miranda-Serrano, Cristina Martinez-Null, Ramón Rubio, Maria Luz Alonso, José Cordero, Cristobal Esteban, Antonio Jiménez, Maria Rosario Carpizo, Gabriel Sanpol, Jaime Corral, Manola Rubio, Antonia Barceló, Javier Piérola, José María Marín

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 follow-up.

Trial registration: ClinicalTrials.gov NCT01335087.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Levels of PlGF according to…
Fig 1. Levels of PlGF according to AHI groups.
Error bars represent 95% confidence intervals. The Kruskal-Wallis test was used for comparisons among groups.

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Source: PubMed

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