People with sleep disorders may have a higher risk of death, heart failure and stroke after having a procedure to open blocked heart arteries, according to new research in the Journal of the American Heart Association.

Acute coronary syndrome is an umbrella term for conditions in which blood supplied to the heart is suddenly blocked. Doctors reopen blocked arteries by threading a catheter through the femoral artery in the groin or the radial artery in the wrist through percutaneous coronary intervention, or PCI, a procedure also known as angioplasty.

“Sleep-disordered breathing, which includes snoring and sleep apnea, has long been recognized as an important risk factor for heart disease,” said Toru Mazaki, M.D., study author and chief physician of the Department of Cardiology at Kobe Central Hospital in Kobe, Japan. “However, there is limited awareness of sleep-disordered breathing among cardiologists who care for PCI patients.”

Researchers monitored 241 acute coronary syndrome patients’ breathing overnight and for an average of 5.6 years, tracking deaths, strokes, recurrent acute coronary syndromes and hospital admissions for heart failure. They found:

  • About 52 percent had sleep-disordered breathing.
  • Of those with sleep-disordered breathing, 21.4 percent had major cardiovascular events.
  • Only 7.8 percent of those without sleep-disordered breathing had major cardiovascular events.
  • The cumulative event-free survival was significantly lower in patients with sleep-disordered breathing than in those without it.

“Our findings suggest that sleep-disordered breathing is an important risk factor for stroke, heart failure and more after PCI for acute coronary syndrome,” Mazaki said. “Doctors and patients should consider sleep studies post-PCI to rule out sleep-disordered breathing or take necessary precautions to restore healthy breathing during sleep.”

Researchers suggest that detecting sleep-disordered breathing should be included in the routine clinical care of hospitalized patients following acute coronary events and angioplasty.

“It may not be feasible for all patients to undergo a fully-equipped sleep study following acute coronary syndrome,” Mazaki said. “Randomized clinical trials with a larger number of patients will provide further information.”