A1 Refereed original research article in a scientific journal
Sleep apnoea is associated with major cardiac events in peripheral arterial disease
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: 43
Issue: 6
First page : 1652
Last page: 1660
Number of pages: 9
ISSN: 0903-1936
DOI: https://doi.org/10.1183/09031936.00130913
Web address : http://api.elsevier.com/content/abstract/scopus_id:84901841855
Abstract
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.
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.
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