Are women with obstructive sleep apnea at high risk for future cardiovascular events?

A new study conducted by Xiao Wang and team showed that obstructive sleep apnea (OSA) was linked to an elevated risk of future episodes, especially in women, in hospitalized acute coronary syndrome (ACS) patients. The findings of this study were published in The European Respiratory Journal.

It is unclear how sex affects the link between obstructive sleep apnea and recurrent cardiovascular events after acute coronary syndrome. Therefore, this study was put up to investigate if OSA is related to long-term cardiovascular outcomes in both men and women with ACS.

Between June 2015 and January 2020, researchers included 2,160 ACS patients who were undertaking portable sleep monitoring in this prospective cohort study. The main objective was to prevent major adverse cardiovascular and cerebrovascular event (MACCE), which includes cardiovascular mortality, myocardial infarction, ischemia-driven revascularization, stroke, or hospitalization for uncontrolled angina or heart failure.

The key findings of this were:

1. A total of 1,927 individuals were added after patients with failed sleep studies, central sleep apnea, consistent continuous positive airway pressure medication, and loss of follow-up were excluded.

2. 298 of them (15.5%) were female and 1,014 (52.6%) of them had OSA. OSA affected 43.0% of women and 54.4% of men, respectively.

3. The cumulative incidence of MACCE across 4,339 person-years (median: 2.9 years; interquartile range: 1.5 to 3.6 years) was substantially greater in OSA groups than in non-OSA groups in the general population.

4. Women, but not males, had a higher chance of developing MACCE when they had OSA. For MACCE, there was no discernible connection between sex and OSA.

5. Higher rates of hospitalization for unstable angina and ischemia-driven revascularization in women were responsible for the increased risk

According to the research team, the outcomes of this study found that obstructive sleep apnea increases the likelihood of a future cardiac incident in women hospitalized with acute coronary syndrome compared to those without OSA.

Reference: 

Wang, X., Fan, J., Guo, R., Hao, W., Gong, W., Yan, Y., Zheng, W., Ai, H., Que, B., Hu, D., Ma, C., Ma, X., Somers, V. K., & Nie, S. (2022). Association of OSA with cardiovascular events in women and men with acute coronary syndrome. In European Respiratory Journal (p. 2201110). European Respiratory Society (ERS). https://doi.org/10.1183/13993003.01110-2022