Obstructive sleep apnea is independently associated with subclinical coronary atherosclerosis among middle-aged women

Abstract

Moderate to severe OSA is independently associated with the presence of CAC in middle-aged women. These results reinforce the concept that women are also susceptible to the cardiovascular consequences of OSA.

Comprehensive coronary plaque assessment in patients with obstructive sleep apnea

“…We found only a trend for higher CAC values in OSA. Although previous studies showed a significant associa- Lutsey et al, 2015;Luyster et al, 2014;Matthews et al, 2011;Medeiros et al, 2017;Seo et al, 2017;Sorajja et al, 2008;Weinreich et al, 2013), this relationship became insignificant after adjusting for BMI (Kim et al, 2010;Luyster et al, 2014;Matthews et al, 2011;Seo et al, 2017) or comorbidities (Seo et al, 2017). In addition, the independent relationship between high CAC and OSA was present only in moderate to severe (Medeiros et al, 2017) and…”

“…Differences in diagnostic methods may lead to underdiagnosis or underestimation of severity in some patients. Moreover, studies also varied in diagnostic criteria for OSA, ranging from AHI score of 5/hr (Matthews et al., ; Medeiros et al., ; Nakanishi‐Minami et al., ; Sorajja et al., ; Weinreich et al., ) to 10/hr (Sharma et al., ), in addition to the combination of objective measures and symptoms (Pusuroglu et al., ). We hypothesised that even mild OSA may be associated with CAD (Hu et al., ); therefore, we chose AHI score of 5/hr as a diagnostic threshold without taking into account symptoms or comorbidities.…”

“…Segment stenosis score was significantly higher in obstructive sleep apnea (p < 0.01) F I G U R E 3 Comparison of coronary artery calcium scores. Coronary artery calcium score tended to be higher in obstructive sleep apnea (p = 0.07) criteria for OSA, ranging from AHI score of 5/hr (Matthews et al, 2011;Medeiros et al, 2017;Nakanishi-Minami et al, 2012;Sorajja et al, 2008;Weinreich et al, 2013) to 10/hr (Sharma et al, 2012), in addition to the combination of objective measures and symptoms (Pusuroglu et al, 2017). We hypothesised that even mild OSA may be associated with CAD (Hu et al, 1999); therefore, we chose AHI score of 5/hr as a diagnostic threshold without taking into account symptoms or comorbidities.…”

“…Several studies have investigated CAD in OSA using computed tomography (Arik et al, 2013;Kent et al, 2013;Kim et al, 2010;Kwon et al, 2014;Lutsey et al, 2015;Luyster, Kip, Aiyer, Reis, & Strollo, 2014;Matthews et al, 2011;Medeiros et al, 2017;Murphy et al, 2017;Nakanishi-Minami et al, 2012;Pusuroglu et al, 2017;Seo et al, 2017;Sharma et al, 2012;Sorajja et al, 2008;Weinreich et al, 2013). However, there were considerable differences in the studied populations and diagnostic tests.…”

“…However, there were considerable differences in the studied populations and diagnostic tests. Particularly, most studies used only coronary artery calcium score (CAC) to evaluate the severity of CAD (Arik et al, 2013;Kim et al, 2010;Kwon et al, 2014;Lutsey et al, 2015;Luyster et al, 2014;Matthews et al, 2011;Medeiros et al, 2017;Seo et al, 2017;Sorajja et al, 2008;Weinreich et al, 2013). However, recent studies demonstrated that coronary plaques are typically non-calcified or partially calcified in OSA (Murphy et al, 2017;Sharma et al, 2012).…”