Traditional risk factors often fail to correlate with event incidence, thus there is a need for novel risk assessment in order to predict events and guide therapy in patients with acute coronary syndromes (ACS) following percutaneous coronary intervention (PCI). Peripheral endothelial dysfunction (PED) and obstructive sleep apnea (OSA) can both predict cardiovascular events, yet the prevalence of PED and OSA in patients hospitalized for ACS following PCI is unknown. Patients in the USA (n=65) and Qatar (n=352) were consented, enrolled following PCI for ACS, and underwent endothelial function testing (EndoPAT) on day 5 and home OSA testing (WatchPAT) following PCI. Baseline demographics at the time of patient admission showed only a modest prevalence of traditional CVD risk factors (Figure 1). The prevalence of PED (defined by EndoPAT<2.0) in this cohort was 73% (mean EndoPAT score of 1.8+0.5), and that of OSA 82% (Apnea Hypopnea Index>5; Figure 1). These functional, non-traditional risk factors were significantly more prevalent (p<0.0001) in this population than traditional risk factors, such as prior MI (6%), hypertension (52%), hyperlipidemia (47%), BMI>30 (43%), diabetes (36%), smoking (30%), CHF (1%), or family history of CVD (37%). Prevalence of both PED and OSA was present in 57% of participants. The current study demonstrated a higher prevalence of PED and OSA following ACS than the traditional CVD risk factors, underscoring their potential value for patient management. Detection and treatment of these functional risk factors may predict events and guide therapy in patients with ACS.


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