Source: Annual Congress 2001 - Cardiovascular pathophysiology in OSA

Abstract

Incidence of a coronary artery disease (CAD) was explored in a consecutive sleep clinic cohort of 294 middle-aged subjects (232 men, 62 women, mean age 49.1 ±] 9.9, range 30-69 yrs) with or without obstructive sleep apnoea (OSA), and without a known heart disease at baseline. Data was collected via the Swedish Hospital Discharge Register covering a 7-year period prior to December 31, 1998 as well as questionnaires. Effectiveness of OSA treatment initiated during the period as well as age, body-mass-index (BMI), systemic hypertension (SHT), diabetes mellitus (DM) and smoking habits were controlled.
Incidence of CAD (angina pectoris and/or myocardial infarction) was observed in 15 of 65 cases (23.1 %) with incompletely treated OSA compared with in 1 of the 26 efficiently treated OSA subjects (3.9%) and in 11 of 203 (5.4 %) subjects without OSA (p<0.001). In a univariate logistic regression analysis, age (odds ratio [OR] 18.0, 95% confidence interval [CI] 3.3-98.8), incompletely treated OSA (OR 5.4, 95% CI 2.4-12.4), and SHT at baseline (OR 3.1, 95% 1.3-7.0), but not BMI, DM and smoking habits, were significant predictors of incident CAD. In a multiple logistic regression model, age (OR 10.2, 95% CI 1.6-63.9) and incompletely treated OSA (OR 4.1, 95% CI 1.8-9.7) remained as independent predictors.
Thus, incompletely treated OSA should be considered as a risk factor for CAD, and the treatment indication should be expanded to include also asymptomatic OSA subjects.
Supported by the Swedish Heart and Lung Foundation.

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Citations should be made in the following way:
Y. Peker, J. Norum, J. Hedner, J. Carlson (Gothenburg, Sweden). Increased incidence of coronary artery disease in obstructive sleep apnoea: a seven-year follow-up. Eur Respir J 2001; 16: Suppl. 31, 3495

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