Insomnia Linked to Recurrent MACE in Coronary Heart Disease

FRIDAY, April 8, 2022 (HealthDay News) -- For patients with coronary heart disease (CHD), insomnia is associated with an increased risk for recurrent major adverse cardiovascular events (MACE), according to a study presented at the annual congress of the European Association of Preventive Cardiology, held virtually from April 7 to 9.

Lars Frojd, from the University of Oslo in Norway, and colleagues examined the prospective association between insomnia and the risk for recurrent MACE in a population of patients with CHD from routine clinical practice. The cohort included 1,068 consecutive patients after a myocardial infarction and/or coronary revascularization procedure.

The researchers identified 364 MACE, which occurred in 225 patients, including 39 cardiovascular deaths. Overall, 45 percent of patients suffered from insomnia at baseline; in the previous week, 24 percent used sleep medications. In an age- and gender-adjusted analysis, the relative risk for recurrent MACE was 1.62 for patients with insomnia compared with patients without insomnia, while the relative risks were 1.49 and 1.48 in an analysis also adjusted for coronary risk factors and in a multiadjusted analysis, including age, gender, coronary risk factors, and cardiovascular morbidity. The relative risk for recurrent MACE in patients with insomnia remained significant at 1.41 when adjusting for symptoms of anxiety and depression. In attributable risk fraction analyses, insomnia accounted for 16 percent of recurrent MACE and was third in importance following smoking and low physical activity (27 and 21 percent, respectively).

"Our study found that insomnia was still significantly associated with heart events even after accounting for symptoms of anxiety and depression," Frojd said in a statement. "The findings suggest that heart patients should be assessed for insomnia and offered appropriate management."

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