CHADS2, CHA2DS2ASc, and New ABCD Scores Predict the Risk of Peripheral Arterial Disease in Patients with Sleep Apnea

Wu, Kwou-Yeung; Kuo, Chang‐Fu; Tsai, Yu-Chen; Hung, Jen‐Yu; Sheu, Chau‐Chyun; Hsu, Chung‐Yao; Wu, Meng‐Ni; Tsai, Ming‐Ju

doi:10.3390/jcm8020188

Cited by 9 publications

(11 citation statements)

References 29 publications

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“…Patients that received a diagnostic code of SA between 1995/03/01 and 2013/12/31 were identified initially. The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes of 780.51, 780.53, and 780.57 were used for the diagnosis of SA [ 8 , 17 ]. The ICD-9-CM codes of 524.6 was used to identify the diagnosis of TMD [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

Lee

Kuo

et al. 2020

IJERPH

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An increased incidence of temporomandibular disorders (TMD) among patients with sleep apnea (SA) has been reported. However, the association between TMD and SA has not been demonstrated in a large-scale study. This population-based cohort study with the Taiwan National Health Insurance (NHI) Research Database aimed to understand the association between SA and TMD. We identified adult patients with suspected SA (identified with diagnostic codes) and excluded those diagnosed with TMD prior to SA. Patients with SA diagnosis after polysomnography were also identified as probable SA patients. The index dates were the dates of their initial SA diagnosis. Ten control subjects were matched, by age and sex, to each SA patient, and were assigned the same index dates as the SA patients. In total, 10,408 suspected SA patients (including 4105 probable SA patients) matched to 104,080 control subjects (including 41,050 subjects matched to the probable SA patients) in this study. The TMD incidence rate was significantly higher in the SA patients than in the control subjects (2.8 vs. 1.0 per thousand-patient-year in probable SA patients vs. the corresponding control subjects, with an adjusted incidence rate ratio [95% confidence interval] = 2.5 [2.3–2.7], p < 0.0001). SA patients significantly showed a higher cumulative incidence of TMD than the corresponding control subjects (p < 0.0001). Multivariable Cox regression analysis revealed SA as an independent risk factor for the development of TMD (adjusted hazard ratio = 2.5 [1.7–3.7], p < 0.0001). In summary, this study confirmed an increased TMD incidence in the SA patients. While treating TMD patients, dentists should pay careful attention to the potential underlying SA.

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Section: Methodsmentioning

confidence: 99%

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

Lee

Kuo

et al. 2020

IJERPH

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Section: Discussionmentioning

confidence: 99%

“…Clinical scoring systems that help guide diagnosis of related cardiovascular disease risk in primary care do not always correlate with presence of PAD, despite sharing many risk factors. 26 Of all 258 patients invited to follow up, only 8 did not attend for DUS imaging. All control group patients were age-and sex-matched from the GP registers and were therefore likely to be representative of the general population.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Peripheral Arterial Disease Registers in UK General Practice: Case-Control Study

Kyle

Boylan

Wilson

et al. 2020

J Prim Care Community Health

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Background: Approximately 20% of the UK population aged 55 to 75 years have evidence of peripheral arterial disease (PAD). PAD affects quality of life and life expectancy if not appropriately diagnosed and managed. At risk patients require accurate diagnosis to ensure optimal treatment to slow disease progression and minimize adverse outcomes. Aim: To assess the accuracy of general practice (GP) registration of the diagnosis of peripheral arterial disease (PAD). Design and Setting: An observational analytic case-control study. As part of a National Institute for Health Research–funded (ISRCTN13301188) project assessing novel diagnostic methods set in GP practice. Methods: A total of 125 patients registered as having PAD and 125 age- and sex-matched controls were recruited from 15 general practices across North East England. The register was then assessed for accuracy of diagnosis. Duplex vascular ultrasound scanning (DUS) undertaken by vascular scientists was used as the gold standard reference for PAD. Results: The PAD register had a sensitivity of 86% (95% CI 77%-92%) and specificity of 74% (95% CI 67%-81%) when compared with DUS. The positive predictive value, however, was 69.6% (95% CI 63%-75%) and negative predictive value 88.8% (95% CI 82%-92%). The overall diagnostic effectiveness of the PAD register was 79.2% (95% CI 73%-84%). Conclusion: This analysis indicates that while PAD is detected with reasonable sensitivity in primary care, many patients registered with a diagnosis of PAD lacked DUS-proven disease. Improved approaches to the objective diagnosis of PAD may improve diagnosis and management of PAD in primary care.

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“…1). The diagnosis of SA was identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes of 780.51, 780.53, and 780.57 [1][2][3][4] . This method for identifying SA patients in the NHIRD has been validated in previous studies 1, [21][22][23] .…”

Section: Study Populationmentioning

confidence: 99%

Increased risk of major depressive disorder in sleep apnea patients in Taiwan

Chen

Kuo

et al. 2021

Sci Rep

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The association between sleep apnea (SA) and depression had been reported in a few previous studies. However, whether SA increases the risk of major depressive disorder (MDD) has not been studied comprehensively in a large-scale study. We performed this population-based cohort study to assess the association between SA and MDD. We identified adult patients having SA from the Taiwan National Health Insurance Research Database and excluded those having MDD before SA diagnosis. Thirty control subjects were randomly selected to match to each SA patient by age and sex. Totally, 10,259 SA patients were matched to 102,590 control subjects. The incidence rate and cumulative incidence of MDD were significantly higher in SA patients than in the control subjects (both p < 0.0001). Multivariable Cox regression analysis showed that SA remained an independent risk factor for incident MDD after adjusting for age, sex, residency, income level, and comorbidities (hazard ratio = 2.9 [95% CI 2.8–3.1], p < 0.0001). In summary, SA patients have an increased risk to develop MDD. Physicians caring for SA patients must pay attention to their psychosocial health status.

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CHADS2, CHA2DS2ASc, and New ABCD Scores Predict the Risk of Peripheral Arterial Disease in Patients with Sleep Apnea

Cited by 9 publications

References 29 publications

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

Accuracy of Peripheral Arterial Disease Registers in UK General Practice: Case-Control Study

Increased risk of major depressive disorder in sleep apnea patients in Taiwan

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