Obstructive sleep apnea increases plaque burden and risk of CAD: Study

Limited evidence is available regarding the association between obstructive sleep apnea (OSA) and coronary plaque assessed by using quantitative coronary CT angiography.

A group of researchers from China conducted a study to examine any associations between obstructive sleep apnea (OSA) severity-related indexes and the presence and burden of coronary plaque.

Cross-sectional data from 692 patients who underwent sleep monitoring and coronary CT angiography were used for this study. Of these patients, 120 (17.3%) underwent polysomnography, and 572 (82.7%) underwent respiratory polygraphy. Multivariable logistic and linear regression analyses were used to investigate the associations of OSA severity-related indexes with the presence, volume, and composition of plaque.

The results of the study are as follows:

· In multivariable analyses, patients with moderate to severe obstructive sleep apnea (OSA) were more likely to have coronary plaques, and plaques were more likely to contain a noncalcified plaque component and a low-density NCP component.

· Furthermore, the apnea-hypopnea index and oxygen desaturation index as continuous variables were both associated with the presence of plaque, NCP, and LD NCP.

· Multivariable linear regression models showed that moderate to severe OSA was associated with NCP volume and LD NCP volume.

· Moreover, the apnea-hypopnea index, oxygen desaturation index, and percentage of nighttime with oxygen saturation < 90% were all significant predictors of LD NCP volume.

· Compared with those with no or mild OSA, patients with severe OSA had a significantly higher total plaque volume, NCP volume, and LD NCP volume.

Thus, the researchers concluded that obstructive sleep apnea (OSA) was independently associated with the presence and burden of coronary plaque, which suggests an increased risk of coronary events.

Reference:

Association Between OSA and Quantitative Atherosclerotic Plaque Burden: A Coronary CT Angiography Study Lu Mi et. al published in the CHEST Journal.

DOI: https://doi.org/10.1016/j.chest.2021.07.040