Undiagnosed Sleep Apnea and Bypass OperaTion
Undiagnosed Sleep Apnea and Bypass OperaTion
Sleep apnea is a prevalent disorder in patients with coronary artery disease. Previous
 studies suggested sleep apnea was associated with coronary plaque burden and future adverse
 cardiovascular events after percutaneous coronary intervention. In the SABOT study, the
 investigators used a FDA-approved portable sleep device to diagnose sleep apnea, and evaluate
 the relationship between sleep apnea and cardiovascular outcomes after non-urgent coronary
 artery bypass surgery.
The SABOT Study is an observational study designed to study the impact of sleep apnea on
 cardiovascular outcomes after non-urgent coronary artery bypass surgery (CABG). Patients
 between the ages of 18 and 90 who are scheduled undergo an non-urgent CABG were eligible for
 the study

 The recruited patients participants were scheduled to undergo a hospital-based overnight
 sleep study using a US Food and Drug Administration-approved portable monitoring devices: the
 Watch-PAT (Itamar Medical, Caesarea, Israel). Watch-PAT is a four-channel unattended sleep
 monitoring device that measures peripheral arterial tone (PAT), pulse oximetry, heart rate,
 and actigraphy from a built-in actigraph. Respiratory events are identified by digital
 vasoconstriction mediated by α-adrenergic receptors that are sensitive to surges in
 sympathetic activity. Respiratory events are considered to be present when one of the
 following three criteria was met: a reduction in PAT amplitude with an acceleration of the
 pulse rate or an increase in wrist activity; a reduction in PAT amplitude with ≥3%
 oxyhemoglobin desaturation; and ≥4% oxyhemoglobin desaturation only. Although manual scoring
 and editing of the Watch-PAT signals are possible, we adopted results generated by the device
 algorithm alone with no intervention by the operator. The diagnosis of sleep apnea is
 confirmed if the AHI was greater than 15 events/h.

 End Points The pre-specified primary end point is a major adverse cardiac and cerebrovascular
 event (MACCE), defined as a composite of cardiovascular mortality, non-fatal myocardial
 infarction, non-fatal stroke, and repeat revascularization.

 The secondary end point comprised sudden cardiac death or resuscitated cardiac arrest,
 all-cause mortality, and hospitalization for heart failure.
Inclusion Criteria:

 -  Patients with coronary artery disease scheduled to undergo non-urgent coronary artery
 bypass surgery

 Exclusion Criteria:

 -  Known sleep apnea on CPAP therapy

 -  Cardiogenic shock on mechanical hemodynamic support

 -  Intubated on mechanical ventilation

 -  Heart failure on oxygen therapy

 -  Long -term alpha blocker therapy

 -  Severe chronic pulmonary disease

 -  Recurrent malignant arrhythmia

 -  Inability to provide informed consent