Faktor-Faktor yang Berhubungan dengan Obstructive Sleep Apnea pada Penderita Gagal Jantung Disertai Fibrilasi Atrium Yang dirawat Di Ruang Rawat Inap Pusat Jantung Terpadu RS. Adam Malik Medan

Abstract

Background: Obstructive sleep apnea (OSA) causes cardiovascular diseases due to intermittent hypoxia, oxidative stress, systemic inflammation, excessive negative intrathoracic pressure, heightened sympathetic activation, and increased blood pressure. These factors can impair myocardial contractility and contribute to the development of heart failure and atrial fibrillation. Epidemiological studies have shown a significant independent association between OSA and both heart failure and atrial fibrillation. Objective: This study aims to identify the factors associated with obstructive sleep apnea (OSA) in patients with heart failure accompanied by atrial fibrillation. Methods: This study was conducted on patients diagnosed with heart failure and atrial fibrillation who were hospitalized in the Integrated Cardiac Care Unit of Adam Malik General Hospital. Data collection began in August 2023 until November 2024. This research is an analytical observational study with a cross sectional design. Results: A total of 51 patients were involved in the study. The majority of respondents were male (34 individuals, 66.7%) and predominantly aged between 60–69 years. The study showed that among patients with heart failure and atrial fibrillation, the most common degree of OSA was mild (16 individuals, 30.8%), followed by moderate (13 individuals, 25.0%), and severe (9 individuals, 17.3%), with an average AHI of 16.78 and a standard deviation of 14.359. Multivariate analysis revealed two significant variables: smoking history and functional capacity (NYHA Class) (p > 0.05). Conclusion: There is a significant relationship between gender and smoking history with the incidence of OSA in patients with heart failure accompanied by atrial fibrillation. In multivariate analysis, smoking history and functional capacity (NYHA Class) were identified as significant variables (p < 0.05).