1132 Sleep Duration in the Month Following Acute Coronary Syndrome and Risk for Major Adverse Cardiovascular Events and Mortality: A Prospective 1-y Study Free

Abstract

Introduction

Sleep disturbance is a risk factor for incident cardiovascular disease (CVD). Yet less is known about the prospective association between disturbed sleep and risk for recurrent cardiac events. We examined whether short sleep duration in the month following hospital evaluation for acute coronary syndrome (ACS) is associated with increased risk for major acute cardiovascular event (MACE) and/or all-cause mortality (ACM) over the following year.

Methods

Patients were enrolled in this prospective observational study after emergency department evaluation for ACS. Habitual sleep duration was assessed at 1 month after hospital discharge with the question: “During the past month, how many hours of actual sleep did you get at night?” A Cox proportional hazards model was used to assess the association between short sleep duration (< 7 hours) during the month following ACS hospital evaluation and MACE/ACM over the 12 months following hospital discharge. Covariates included age, sex, race/ethnicity, cardiac severity (GRACE-Risk score), comorbidities (Charlson Comorbidity Index), and ACS diagnosis status (confirmed ACS vs. rule-out). Because of the small number of participants with long sleep duration (>9 hours) and the potential association of long sleep with adverse outcomes, participants reporting >9 hours of sleep were excluded from analyses.

Results

The sample included 1,239 patients. Mean (SD) age was 60.6 (12.9) years and 49.6% were female. Mean sleep duration was 5.97 (1.64) hours, with 59.6% reporting sleep duration < 7 hours and 40.36% with sleep duration 7-9 hours. During the follow-up period, 5.2% experienced MACE/ACM. Short sleep duration (vs. not short) had a marginally significant association with 12-month MACE/ACM (HR=1.64; 95% CI: 0.94, 2.84) in covariate adjusted analyses. In sensitivity analysis defining short sleep as < 6 hours and comparing to sleep duration of 6-9 hours, the association of short sleep with 12-month MACE/ACM was statistically significant (HR=1.90; 95% CI: 1.15, 3.12).

Conclusion

Short sleep duration following ACS hospital evaluation is prevalent and is associated with increased risk of MACE/ACM within the following 12 months. Findings suggest that short sleep is an important modifiable behavioral factor to consider after ACS, and that targeting short sleep duration in cardiac patients may help reduce secondary cardiovascular risk.

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