Association between apnea-hypopnea index and coronary artery calcification: a systematic review and meta-analysis

Hao, Wen; Wang, Xiao; Fan, Jingyao; Zeng, Yaping; Ai, Hui; Nie, Shaoping; Wei, Yongxiang

doi:10.1080/07853890.2021.1875137

Cited by 7 publications

(4 citation statements)

References 49 publications

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“…In a meta-analysis, Hao et al, showed an association between OSA and the presence of atherosclerotic lesions in patients without symptoms of heart disease. Furthermore, in a pairwise comparison, they indicated that the CACS might depend on the severity of OSA, which corresponds to our results [ 31 ].…”

Section: Discussionsupporting

confidence: 91%

Obstructive Sleep Apnea as a Predictor of a Higher Risk of Significant Coronary Artery Disease Assessed Non-Invasively Using the Calcium Score

Macek

Michałek-Zrąbkowska

Dziadkowiec-Macek

et al. 2023

Life

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The aim of this study was to assess the coronary artery calcium score in patients with obstructive sleep apnea (OSA). The study group (group A) consisted of 62 patients with diagnosed obstructive sleep apnea (mean age: 59.12 ± 9.09 years, mean AHI index in polysomnography: 20.44 ± 13.22/h), and 62 people without diagnosed obstructive sleep apnea (mean age 59.50 ± 10.74 years) constituted the control group (group B). The risk of significant coronary artery disease was assessed in all patients, based on the measurement of the coronary artery calcium score (CACS) using computed tomography. The following cut-off points were used to assess the risk of significant coronary artery disease: CACS = 0—no risk, CACS 1–10—minimal risk, CACS 11–100—low risk, CACS 101–400—moderate risk, and CACS > 400—high risk. Group A was characterized by statistically significantly higher CACS than group B (550.25 ± 817.76 vs. 92.59 ± 164.56, p < 0.05). No risk of significant coronary artery disease was statistically significantly less frequent in group A than in group B (0.0% vs. 51.6%, p < 0.05). A high risk of significant coronary artery disease was statistically significantly more frequent in group A than in group B (40.3% vs. 4.8%, p < 0.05). In group A, patients with severe OSA and patients with moderate OSA had statistically significantly higher CACS than patients with mild OSA (910.04 ± 746.31, 833.35 ± 1129.87, 201.66 ± 192.04, p < 0.05). A statistically significant positive correlation was found between the AHI and CACS (r = 0.34, p < 0.05). The regression analysis showed that OSA, male gender, older age, type 2 diabetes, peripheral arterial disease, and smoking were independent risk factors for higher CACS values. AHI ≥ 14.9 was shown to be a predictor of a high risk of significant coronary artery disease with a sensitivity and specificity of 62.2% and 80.0%, respectively. In summary, obstructive sleep apnea should be considered an independent predictive factor of a high risk of significant coronary artery disease (based on the coronary artery calcium score).

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Section: Discussionsupporting

confidence: 91%

Obstructive Sleep Apnea as a Predictor of a Higher Risk of Significant Coronary Artery Disease Assessed Non-Invasively Using the Calcium Score

Macek

Michałek-Zrąbkowska

Dziadkowiec-Macek

et al. 2023

Life

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“…Besides hypertension, OSA plays a significant risk factor in other CVDs. The studies by Heilbrunn ES et al [ 12 ] and Hao W et al [ 13 ] are particularly notable for highlighting the impact of OSA on an elevated risk of cardiovascular mortality, as well as coronary artery calcification (CAC). This is in accordance with the 2005 retrospective study, which stated that the relative risk of sudden cardiac death (SCD) was 2.57-fold higher between midnight and 6 a.m. in patients with OSA compared with the general population.…”

Section: Reviewmentioning

confidence: 99%

The Interplay Between Sleep Disorders and Cardiovascular Diseases: A Systematic Review

Ravichandran,

Gupta,

Singh

et al. 2023

Cureus

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Non-communicable diseases (NCDs) have emerged as the predominant cause of global mortality, resulting in a substantial annual loss of human lives. Among these conditions, cardiovascular diseases (CVD) stand out as the primary cause of death. The majority of CVD cases can be attributed to certain factors that, upon modification, have the potential to significantly decrease both the incidence and severity of the disease. For numerous years, the impact of sleep disorders on cardiovascular health has been a prominent subject of extensive discussion. Chronic sleep disturbances are known to have a range of negative health consequences, with the relationship between sleep apnea and hypertension being well-established through numerous studies. However, further exploration is needed to understand other disease associations with sleep apnea and to examine the impact of various sleep disorders, aside from sleep apnea, on cardiovascular health. This systematic review assesses the available evidence on the association between various sleep disorders and cardiovascular diseases by addressing the question: Do sleep disorders contribute to or exacerbate cardiovascular diseases? After a comprehensive review, we identified 122 articles. Following this initial review, seven papers directly aligned with our research topic. Subsequently, we meticulously assessed the remaining seven papers, all meeting our predetermined criteria. Our analysis showed a strong correlation between sleep disruptions and cardiovascular health. Numerous sleep disorders, such as narcolepsy, central sleep apnea, obstructive sleep apnea, and insomnia, have shown different effects on cardiovascular outcomes. Increased risks of illnesses such as acute coronary syndrome (ACS), hypertension, cardiovascular mortality, and coronary artery calcification were included in these consequences. This systematic review underscores the need for early identification and comprehensive management of sleep disturbances to mitigate their potential adverse effects on cardiovascular well-being. Integrating strategies that address sleep disorders and cardiovascular health is imperative in enhancing overall health outcomes. This study paves the way for more effective preventive and therapeutic approaches by focusing on the relationship between sleep disorders and cardiovascular diseases.

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“…In a meta-analysis, OSA has been found to independently increase the risk of subclinical CAD as measured by coronary artery calcification score [ 57 ]. Likewise, OSA was found to be an independent predictor of atherosclerotic plaque progression and vulnerability [ 58 ].…”

Section: Clinical Comorbidities Associated With Osamentioning

confidence: 99%

Obstructive Sleep Apnea and Cardiovascular Diseases: Sad Realities and Untold Truths regarding Care of Patients in 2022

Gunta

Jakulla

Ubaid

et al. 2022

Cardiovascular Therapeutics

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Obstructive sleep apnea (OSA) is one of the most common and serious sleep-related breathing disorders with a high prevalence among patients with cardiovascular (CV) diseases. Despite its widespread presence, OSA remains severely undiagnosed and untreated. CV mortality and morbidity are significantly increased in the presence of OSA as it is associated with an increased risk of resistant hypertension, heart failure, arrhythmias, and coronary artery disease. Evaluation and treatment of OSA should focus on recognizing patients at risk of developing OSA. The use of screening questionnaires should be routine, but a formal polysomnography sleep study is fundamental in establishing and classifying OSA. Recognition of OSA patients will allow for the institution of appropriate therapy that should alleviate OSA-related symptoms with the intent of decreasing adverse CV risk. In this review, we focus on the impact OSA has on CV disease and evaluate contemporary OSA treatments. Our goal is to heighten awareness among CV practitioners.

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Association between apnea-hypopnea index and coronary artery calcification: a systematic review and meta-analysis

Cited by 7 publications

References 49 publications

Obstructive Sleep Apnea as a Predictor of a Higher Risk of Significant Coronary Artery Disease Assessed Non-Invasively Using the Calcium Score

Obstructive Sleep Apnea as a Predictor of a Higher Risk of Significant Coronary Artery Disease Assessed Non-Invasively Using the Calcium Score

The Interplay Between Sleep Disorders and Cardiovascular Diseases: A Systematic Review

Obstructive Sleep Apnea and Cardiovascular Diseases: Sad Realities and Untold Truths regarding Care of Patients in 2022

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