RESUMO
El propósito de esta revisión es analizar la relación entre la apnea obstructiva del sueño y la enfermedad arterial coronaria. Se exponen las evidencias epidemiológicas del trastorno respiratorio y de su asociación con la cardiopatía isquémica, los factores comunes de riesgo cardiovascular, las interacciones fisiopatológicas entre ambos trastornos, la evolución clínica y el efecto del tratamiento sobre la fisiopatología y el pronóstico.
The purpose of this review is to analyse the relation between obstructive sleep apnea and coronary disease. We present epidemiological data on the respiratory disorder and its association with ischemic cardiopathy, as well as common cardiovascular risk factors, physiopathological interactions between both conditions, clinical evolution and impact of treatment on prognosis.
Assuntos
Humanos , Isquemia Miocárdica/complicações , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Disfunção Ventricular/etiologiaRESUMO
The purpose of this review is to analyse the relation between obstructive sleep apnea and coronary disease. We present epidemiological data on the respiratory disorder and its association with ischemic cardiopathy, as well as common cardiovascular risk factors, physiopathological interactions between both conditions, clinical evolution and impact of treatment on prognosis.
Assuntos
Isquemia Miocárdica/complicações , Apneia Obstrutiva do Sono/complicações , Humanos , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Disfunção Ventricular/etiologiaRESUMO
OBJECTIVE: to measure the frequency of type 2 diabetes mellitus (T2DM) in patients with confirmed HCV infection. METHODS: we studied 125 adults reactive to anti-HCV antibodies (62.4 % women, mean age 46.8 years) who received confirmatory RT-PCR testing for viremia (63.2 % HCV-RNA-positive). RESULTS: twenty-two patients had T2DM (17.6 %, 95 % confidence interval: 11.8-25.3 %; mean National prevalence: 14.4 %), more frequent among patients with detectable viremia than in negative cases (23.3 % vs. 9.6 %, respectively; p = 0.04), and among those with advanced liver disease, than in compensated patients (28.9 % vs. 11.3 %, respectively; p = 0.01). Fourteen (17.7 %) patients received interferon-based treatment and 6 (42.8 %) had sustained virology response. None of the 6 responders had T2DM, but 2 of the 8 (25 %) non-responders had diabetes. T2DM patients were older than those without diabetes (57.7 vs. 44.5 years, p < 0.001), and after multivariate analysis, only age was significantly associated with diagnosis of T2DM. CONCLUSIONS: T2DM was highly prevalent among patients with chronic HCV infection. Age was the most important determining factor.
