A1 Journal article – refereed
Sleep apnoea is associated with major cardiac events in peripheral arterial disease

List of Authors: Utriainen K, Airaksinen JK, Polo O, Laitio R, Pietilä MJ, Scheinin H, Vahlberg T, Leino KA, Kentala ES, Jalonen JR, Hakovirta H, Parkkola R, Sirtanen S, Laitio TT
Publisher: ERSpublications
Publication year: 2014
Journal: European Respiratory Journal
Journal name in source: European Respiratory Journal
Volume number: 43
Issue number: 6
Number of pages: 9
ISSN: 0903-1936


Obstructive sleep apnoea (OSA) is associated with atherosclerosis and cardiovascular events.

Peripheral arterial disease (PAD) represents severe atherosclerosis with a high mortality after vascular

surgery. The role of OSA in the prognosis of these patients is not yet established.

84 patients (aged 67¡9 years) scheduled for sub-inguinal surgical revascularisation were enrolled for

preoperative polysomnography. The threshold for significant OSA was an apnoea/hypopnoea index

o20 events?h-1. Major adverse cardiovascular and cerebrovascular events (MACCE), including cardiac

death, myocardial infarction, coronary revascularisation, angina pectoris requiring hospitalisation and

stroke, were used as a combined end-point.

During follow-up (median 52 months), 17 out of 39 patients with and six out of 45 patients without

significant OSA suffered MACCE. In the multivariate Cox regression, the primary predictors of MACCE

were significant OSA (hazard ratio (HR) 5.1 (95% CI 1.9–13.9); p50.001) and pre-existing coronary artery

disease (HR 4.4 (95% CI 1.8–10.6); p50.001). Other significant predictors were a o4 year history of PAD

(HR 3.8 (95% CI 1.3–11.5); p50.02) and decreasing high-density lipoprotein/total cholesterol ratio (HR

0.95 per percentage (95% CI 0.90–1.00); p50.048).

OSA is associated with poor long-term outcome in patients with PAD following revascularisation.

OSA might have an important role in the pathogenesis of cardiovascular morbidity and mortality in

these patients.

Last updated on 2019-18-06 at 07:30