Resolution of ST deviation in patients with and without sleep disordered breathing early after acute myocardial infarction

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Background: In patients with ST elevation myocardial infarction (STEMI) sleep disordered breathing (SDB) is associated with a mismatch of oxygen supply and demand due to repetitive desaturations and increased cardiac workload. Thus, we hypothesize that SDB is associated with impaired ST deviation resolution after STEMI. Objective: The aim of this study was to evaluate whether patients with SDB have an impaired ST deviation resolution within 24h after STEMI compared to those without. Methods: This is an ancillary cross-sectional analysis of the screening visit of patients enrolled in TEAM-ASV I (Treatment of sleep apnea Early After Myocardial infarction with Adaptive Servo-Ventilation trial, NCT02093377) at the University Hospital Regensburg. In this analysis patients with STEMI and successful percutaneous Intervention (PCI) were stratified into those with (apnea–hypopnea index, AHI≥15/h) and without SDB (AHI<15/h). ST deviation was measured at the J-point in infarct specific leads. Relative ST deviation resolution (decrease from previous value) was assessed using ECGs from up to 24h before and within 24h after PCI. Results: The analysis population included 59 patients (76% male, median age 59 years IQR [51;66], 28 (47%) with SDB, 31 (53%) without SDB). Before PCI median ST deviation was similar in both groups (1.46 [0.97;2.62] vs. 1.68 [1.13;3.00] mV, p=0.48). There was no significant difference in ST resolution after PCI in both groups (-67 [-83;-26] vs. -60 [-75;-33] %, p=0.54) even after accounting for age, sex, and infarct location (p>0.05, Analysis of Covariance, ANCOVA). Conclusion: In this population SDB was not associated with impaired ST resolution after STEMI.

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