Movement Disorders

Takatoshi Kasai, MD, PhD, and Shoichiro Yatsu, MD, PhD, on RLS Prevalence in Patients With CAD

A new study investigated the prevalence and significance of restless legs syndrome (RLS) in patients with coronary artery disease (CAD).1 Neurology Consultant spoke with the lead authors about their study and what the results mean for clinical practice.

Takatoshi Kasai, MD, PhD, is an associate professor in the Department of Cardiovascular Medicine at Juntendo University School of Medicine, an associate professor of Cardiovascular Respiratory Sleep Medicine at Juntendo University Graduate School of Medicine, and director of the Sleep and Sleep-Disordered Breathing Center at the Juntendo University Hospital in Tokyo, Japan.

Shoichiro Yatsu, MD, PhD, is an assistant professor in the Department of Cardiovascular Medicine at Juntendo University School of Medicine and an associate professor in the Department of Cardiovascular Medicine at Juntendo Tokyo Koto Geriatric Medical Center in Tokyo, Japan.

 

NEUROLOGY CONSULTANT: Can you give us some background on your study? How did it come about?

Takatoshi Kasai and Shoichiro Yatsu: RLS is a sleep-related movement disorder and frequently coexists with periodic leg movements (PLM). We previously reported2 the association between PLM and clinical outcomes in patients with acute decompensated heart failure. Although RLS is associated with incident cardiovascular disease, limited data are available regarding prevalence and clinical importance of RLS in patients with cardiovascular disease. Thus, we investigated prevalence and clinical importance of RLS in patients with CAD.

NEURO CON: Tell us more about your findings. Did any of them surprise you?

TK and SY: Prevalence of RLS in patients with CAD was relatively higher than reported prevalence of RLS in the general population (especially when compared with Asian population). There was no significant difference in characteristics of patients, including iron and renal function between patients with and without RLS. In addition, RLS significantly disrupted patients’ subjective sleep quality and health-related quality of life. We were surprised that the prevalence of RLS is high and that despite similar patients’ characteristics, RLS is associated with poor subjective sleep quality and poor quality of life in patients with CAD.

NEURO CON: How will your results impact clinical practice?

TK and SY: Our results suggest that RLS is not a rare comorbidity in patients with CAD and that coexisting RLS may be clinically important by disrupting patient sleep and impairing health-related quality of life. Thus, cardiologists should consider identifying RLS and treating RLS to keep their patients’ sleep quality and quality of life better.

NEURO CON: What is the next step in your research? What else do you plan to study?

TK and SY: Although we elucidated that RLS was independently associated with poor sleep quality and the physical component of quality of life, it remains unclear whether RLS is a factor associated with impaired long-term outcomes and whether RLS is a therapeutic target to improve sleep quality and quality of life in patients with CAD. Thus, we would investigate whether RLS worsens the prognosis in the long-term follow-up study and whether RLS treatment improves sleep and quality of life in the interventional clinical trial among patients with CAD.

NEURO CON: What is the key takeaway from your study for neurologists?

TK and SY: We would suggest neurologists to pay attention to patients with CAD because of relatively high prevalence of RLS and to consider treatments of RLS to keep patients’ sleep quality and health-related quality of life better with a collaboration with cardiologists.

 

REFERENCES:

  1. Yatsu S, Kasai T, Suda S, et al. Prevalence and significance of restless legs syndrome in patients with coronary artery disease [published online February 23, 2019]. Am J Cardiol. https://doi.org/10.1016/j.amjcard.2019.02.017.
  2. Yatsu S, Kasai T, Suda S, et al. Impact on clinical outcomes of periodic leg movements during sleep in hospitalized patients following acute decompensated heart failure. Circ J. 2017;81:495-500. doi:10.1253/circj.CJ-16-0934.