Poor sleep quality is independently linked to greater CAD severity in geriatric ACS patients, representing a modifiable risk factor that can reduce morbidity and mortality in this high-risk group.
Key Findings
Results
Poor sleep quality was significantly associated with higher SYNTAX scores (greater coronary artery disease severity) in geriatric ACS patients.
Study included 308 patients aged 65 years and older admitted with ACS who underwent coronary angiography between May 2022 and June 2025
Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at 6-month follow-up, with scores >5 indicating poor quality
CAD severity was quantified by SYNTAX score from angiograms
Association between poor sleep quality and higher SYNTAX scores was statistically significant (p < 0.001)
Results
Poor sleep quality was associated with lower ejection fraction in geriatric ACS patients.
The difference in ejection fraction between poor and good sleep quality groups was statistically significant (p < 0.001)
Reduced ejection fraction was identified as an associated factor of poor sleep in multivariable logistic regression (p = 0.030)
Results
Poor sleep quality was associated with elevated inflammatory and cardiac stress biomarkers.
CRP was higher in poor sleep quality group (median 5.1 vs. 4.05, p = 0.029)
NT-proBNP was higher in poor sleep quality group (median 748.5 vs. 595, p = 0.034)
Results
Poor sleep quality was associated with lower glomerular filtration rate and higher hypertension prevalence.
Lower glomerular filtration rate was significantly associated with poor sleep quality (p = 0.025)
Higher hypertension prevalence was observed in the poor sleep quality group (p = 0.034)
Hypertension was identified as an independent associated factor of poor sleep in multivariable logistic regression (p = 0.011)
Results
ST-elevation myocardial infarction (STEMI) was more common in patients with poor sleep quality.
STEMI was more common in subjects with poor sleep quality
STEMI was identified as an associated factor of poor sleep in multivariable logistic regression (p = 0.045)
Results
Multivariable logistic regression identified intermediate and high SYNTAX scores as independently associated with poor sleep quality.
Intermediate SYNTAX score was independently associated with poor sleep quality (p = 0.003)
High SYNTAX score was independently associated with poor sleep quality (p = 0.009)
Other independent factors identified were hypertension (p = 0.011), reduced ejection fraction (p = 0.030), and STEMI (p = 0.045)
Methods
This was a retrospective observational cohort study of geriatric ACS patients at a tertiary cardiology department.
Study design was retrospective observational cohort
308 patients aged 65 years and older were included
Patients were admitted with ACS and had undergone coronary angiography
Data collection period was May 2022 to June 2025
PSQI was assessed at 6-month follow-up rather than at admission
What This Means
This research studied the relationship between sleep quality and the severity of blocked heart arteries in older adults (aged 65+) who were hospitalized for acute coronary syndrome (a category that includes heart attacks). The researchers assessed sleep quality using a validated questionnaire called the Pittsburgh Sleep Quality Index (PSQI) at a 6-month follow-up, and measured the severity of coronary artery blockages using a scoring system called the SYNTAX score obtained from coronary angiography. Among the 308 patients studied, those who reported poor sleep quality had significantly more severe coronary artery disease, lower heart pumping function, higher levels of inflammation and heart stress markers in their blood, worse kidney function, and higher rates of high blood pressure and severe heart attacks.
When accounting for multiple factors simultaneously using statistical modeling, poor sleep quality remained independently linked to more severe coronary artery disease, even after adjusting for other variables. Conversely, having more severe coronary artery disease, high blood pressure, reduced heart function, and a specific type of severe heart attack (STEMI) were all associated with reporting poor sleep quality. This suggests a potential bidirectional relationship between sleep problems and heart disease severity in older adults.
This research suggests that sleep quality may serve as a meaningful indicator of heart disease severity in elderly patients recovering from acute coronary events. Because sleep quality is considered a modifiable risk factor — meaning it can potentially be improved through interventions — the authors highlight its relevance as a target for reducing complications and death in this high-risk older adult population. The findings point to the potential value of routinely assessing sleep in elderly heart disease patients, though the retrospective nature of the study means causality cannot be definitively established.
Konte H, Dervis E, Alyan O, Aras D. (2026). Sleep Quality as a Predictor of Coronary Artery Disease Severity in Geriatric Acute Coronary Syndrome.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62010101