In our study, only 60% of the OSA patients accepted CPAP and used their device regularly. However, this rate might be optimized if CPAP is not only recom mended as a means of controlling symptoms of OSA but also as part of their CAD treatment. In this regard it was shown, that adherence to CPAP might reach nearly 100% in patients with coronary artery disease and sleep http://www.selleckchem.com/products/CP-690550.html apnea, even without daytime sleepiness. By all means, patients with risk profile for OSA should be screened for nocturnal breathing disorders to optimize cardiovascular risk and the risk of restenosis after percutaneous coronary intervention. Limitations of the study There are several limitations of the study first of all, we did not carry out overnight polysomnography, therefore we Inhibitors,Modulators,Libraries can not rule out sleep relating breathing disorders in all patients in group I.
Still, minimal oxygen saturation and AHI are the common parameters describing the sever ity of nocturnal breathing Inhibitors,Modulators,Libraries disorders. Furthermore, there were no follow up sleep studies at the time of the second angiography study. Another limitation refers to the study design, since there was no randomization of the OSA patients with regard to CPAP. Therefore, we can not exclude some misclassification Inhibitors,Modulators,Libraries bias. In this regard, there was a higher rate of stent placements in patients with CPAP therapy compared to patients without CPAP ther apy within the OSA group, which might have contributed to the less pronounced late lumen loss in CPAP treated patients. Further limitation refers to the study design, which does not allow to verify a causal relationship.
In summary, patients with OSA and coronary artery dis ease have a higher degree of late lumen loss, which is a marker of restenosis and vessel remodeling after elective percutaneous intervention. Abbreviations LAD Left anterior descending Inhibitors,Modulators,Libraries artery. LCX Left circumflex coronary artery. RCA Right coronary artery. PCI Percuta neous coronary intervention. PTCA Percutaneous trans luminal coronary angioplasty. AHI Apnea hypopnea index. CPAP Continuous positive airway pressure. OSA Obstructive sleep apnea. ACT Acitvated clotting time. BMI Body mass index. CAD Coronary artery disease. EF Left ventricular ejection fraction. Introduction Inhaled corticosteroids are the cornerstone of anti inflammatory treatment in asthma. However, many patients remain symptomatic despite high doses of inhaled corticosteroids, even when combined with long acting beta agonists.
New asthma treatments tar geting inflammation are needed. Adenosine monophosphate and cyclic guano sine monophosphate cause smooth muscle relaxation and regulate immune cell function. Inhibitors,Modulators,Libraries These intracellular signalling molecules are inactivated by the phosphodiesterase family of metallophosphohy drolases, which can lead to smooth muscle contraction and increased immune cell activation. Therefore, the non selective Trichostatin A price oral PDE inhibitor theophylline has been used as a treatment for asthma for many years.