{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:06:23Z","timestamp":1793437583016,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,1,23]]},"abstract":"\n Background<\/jats:title>\n \n Excessive daytime sleepiness (\n EDS<\/jats:styled-content>\n ), a common symptom among patients with sleep\u2010disordered breathing, is closely associated with the development of cardiovascular diseases, but its long\u2010term prognostic value is not completely understood. The aim of this study was to investigate whether\n EDS<\/jats:styled-content>\n would be an independent prognostic factor after myocardial infarction.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We prospectively recruited 112 post\u2013myocardial infarction patients. The Epworth Sleepiness Scale was completed before polysomnography, and\n EDS<\/jats:styled-content>\n was defined as a score \u226511. After exclusion of 8 patients who accepted treatment with continuous positive airway pressure, 104 patients were followed up for 48\u00a0months. The primary composite end point was major adverse cardiac events. Patients with\n EDS<\/jats:styled-content>\n had higher rates of major adverse cardiac events (48.4% versus 27.4%, \u03c7\n 2<\/jats:sup>\n =5.27,\n P<\/jats:italic>\n =0.022) and reinfarction (29.0% versus 5.5%, \u03c7\n 2<\/jats:sup>\n =13.51,\n P<\/jats:italic>\n =0.0002) compared with those without\n EDS<\/jats:styled-content>\n . In the Cox proportional hazards model, patients with\n EDS<\/jats:styled-content>\n had 2.15 times (95% confidence interval, 1.08\u20134.18;\n P<\/jats:italic>\n =0.030) higher crude risk of major adverse cardiac events, with prognostic significance persisting after adjusting for age, diabetes mellitus, depression, left ventricular ejection fraction, apnea\u2013hypopnea index, and nocturnal nadir oxygen saturation (hazard ratio: 2.13, 95% confidence interval, 1.04\u20134.26,\n P<\/jats:italic>\n =0.039). Furthermore, among participants with moderate to severe sleep\u2010disordered breathing, the presence of\n EDS<\/jats:styled-content>\n was associated with higher risk of major adverse cardiac events than those without\n EDS<\/jats:styled-content>\n , after adjusting for age and nadir oxygen saturation (hazard ratio: 3.17, 95% confidence interval, 1.22\u20137.76,\n P<\/jats:italic>\n =0.019).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n EDS<\/jats:styled-content>\n may be an independent prognostic factor of adverse outcome in post\u2013myocardial infarction patients with moderate to severe sleep\u2010disordered breathing. Evaluation of\n EDS<\/jats:styled-content>\n may shed new light on risk stratification and identify treatment responders for this patient population.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007221","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T20:10:59Z","timestamp":1516392659000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":87,"title":["Excessive Daytime Sleepiness Independently Predicts Increased Cardiovascular Risk After Myocardial Infarction"],"prefix":"10.1161","volume":"7","author":[{"given":"Jiang","family":"Xie","sequence":"first","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]},{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima H.","family":"Sert Kuniyoshi","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naima","family":"Covassin","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prachi","family":"Singh","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apoor S.","family":"Gami","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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