Archive | 2021
The effects of obstructive sleep apnea and high-sensitivity C-reactive protein on clinical outcome in off-pump coronary artery bypass grafting
Abstract
\n Purpose\n\nThis study aimed to investigate the relationship between obstructive sleep apnea (OSA) and high-sensitivity C-reactive protein (hs-CRP) to determine their effects on postoperative complications and clinical outcomes during hospitalization in patients undergoing off-pump cardiac artery bypass grafting (OPCABG).\nMethods\n\nThis prospective, single-center study enrolled patients who underwent OPCABG. OSA was evaluated using a portable sleep monitor before OPCABG. Spearman correlation was performed to investigate the relationship between hs-CRP and polygraphy test indicators; regression analysis was performed to determine whether hs-CRP is an independent influencing factor for postoperative atrial fibrillation, duration of hospitalization, and hospital cost.\nResults\n\nPartial pressure of carbon dioxide (P\u2009=\u20090.033), high-sensitivity C-reactive protein (hs-CRP) (P\u2009=\u20090.001), apnea hypopnea index (AHI) (P\u2009=\u20090.000), mean apnea time (P\u2009=\u20090.000), maximum apnea time (P\u2009=\u20090.000), and ODI\u2009≥\u20093% (P\u2009=\u20090.000) were significantly higher in the moderate–severe OSA group than in the absent–mild OSA group. LVEF (P\u2009=\u20090.034), lowest arterial oxygen saturation (SaO2) (P\u2009=\u20090.000), and mean SaO2 (P\u2009=\u20090.000) were significantly lower in the moderate–severe OSA group. Hs-CRP levels correlated with AHI (rs\u2009=\u20090.235, P\u2009=\u20090.009), ODI\u2009≥\u20093% (rs\u2009=\u20090.228, P\u2009=\u20090.011), lowest SaO2 (rs\u2009=\u20090.186, P\u2009=\u20090.040), and mean SaO2 (rs\u2009=\u20090.331, P\u2009=\u20090.000). AHI independently correlated with hs-CRP levels (P\u2009=\u20090.01); hs-CRP was an independent risk factor for post-CABG atrial fibrillation (POAF) (OR\u2009=\u20091.17, P\u2009=\u20090.006); and hs-CRP level independently correlated with duration of hospitalization (P\u2009=\u20090.002) and hospital cost (P\u2009=\u20090.040).\nConclusion\n\nHs-CRP levels are closely related to the degree of OSA and have potential utility in predicting POAF, duration of hospitalization, and hospital costs in patients undergoing OPCABG.