Association between late sleeping and major adverse cardiovascular events in patients with percutaneous coronary intervention.

ABSTRACT

BACKGROUND: Sleeping late has been a common phenomenon and brought harmful effects to our health. The purpose of this study was to investigate the association between sleep timing and major adverse cardiovascular events (MACEs) in patients with percutaneous coronary intervention (PCI). METHODS: Sleep onset time which was acquired by the way of sleep factors questionnaire in 426 inpatients was divided into before 2200, 2200 to 2259, 2300 to 2359 and 2400 and after. The median follow-up time was 35 months. The endpoints included angina pectoris (AP), new myocardial infarction (MI) or unplanned repeat revascularization, hospitalization for heart failure, cardiac death, nonfatal stroke, all-cause death and the composite endpoint of all events mentioned above. Cox proportional hazards regression was applied to analyze the relationship between sleep timing and endpoint events. RESULTS: A total of 64 composite endpoint events (CEEs) were reported, including 36 AP, 15 new MI or unplanned repeat revascularization, 6 hospitalization for heart failure, 2 nonfatal stroke and 5 all-cause death. Compared with sleeping time at 2200-2259, there was a higher incidence of AP in the bedtime ≥ 2400 group (adjusted HR 5.089; 95% CI 1.278-20.260; P = 0.021). In addition, bedtime ≥ 2400 was also associated with an increased risk of CEEs in univariate Cox regression (unadjusted HR 2.893; 95% CI 1.452-5.767; P = 0.003). After multivariable adjustments, bedtime ≥ 2400 increased the risk of CEEs (adjusted HR 3.156; 95% CI 1.164-8.557; P = 0.024). CONCLUSION: Late sleeping increased the risk of MACEs and indicated a poor prognosis. It is imperative to instruct patients with PCI to form early bedtime habits.