Impact of obstructive sleep apnea in recruitment of coronary collaterality during inaugural acute myocardial infarction

Background: Obstructive sleep apnea (OSA) may lead to myocardial preconditioning by increasing coronary collateral vessel recruitment in patients with acute coronary occlusion. Aim: To determine the relationship between the severity of obstructive sleep apnea and coronary collaterality during acute myocardial infarction. Methods: This study prospectively included 71 patients with an inaugural myocardial infarction who had undergone a coronary angiography within 24. h of onset. All patients underwent an overnight polygraph before discharge and were classified according to the apnea-hypopnea index (AHI). Coronary collaterals were scored by visual analyses and according to the Rentrop grading system. Results: Mean age was 59. ±. 11. years and 83% of patients were men. All patients had complete or subtotal occlusion of the infarct-related artery. After the sleep study, patients were divided into two groups: 25 were suffering from OSA (AHI > 15/h). Patients with OSA showed better collateral vessel development (Rentrop score ≥ 1) compared to non-OSA patients (68 vs 41%, P= 0.032). AHI was significantly higher in patients with developed coronary collaterals (Rentrop ≥ 1) compared to those without collaterality (17.74 ± 13.2 vs 12.24 ± 10.9, P= 0.025). Conclusion: Coronary collateral development may be increased in OSA patients who are presenting with a first myocardial infarction.