Author + information
- Jeanne Ong,
- Chieh Yang Koo,
- Germaine Loo,
- Huay-Cheem Tan and
- Chi-Hang Lee
Background: Moderate-Severe (M-S) obstructive sleep apnea (OSA) (apnea-hypopnea index, AHI >15), compared with no-mild OSA, predicted adverse events after percutaneous coronary intervention (PCI) in the multi-center Sleep and Stent Study. The American Thoracic Society has advocated for further data on mild OSA (AHI 5-14.9)- a highly prevalent disorder with unknown impact on cardiovascular complications.
Methods: 1311 patients were reclassified into 3 groups: no (n=310), mild (n=407), and M-S (n=594) OSA. The primary end point was MACCE – a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke and unplanned revascularization. The median follow-up was 1.9 years.
Results: Compared to the M-S OSA group, the mild OSA group was less likely to be male and more likely to be Indian, had a lower BMI, prevalence of hypertension and diabetes mellitus, and were less likely to receive anti-hypertensive medications (p<0.05 for all). The crude cumulative incidence of MACCE (Fig.) was highest in M-S OSA (2-year estimate, 12.7%), similar in mild (8.8%) and no (7.4%) OSA groups (p=0.005). By Cox regression analysis, M-S OSA reported an increased risk of MACCE (adjusted hazard ratio, 1.62; 95% confidence interval, 1.06-2.47; P=0.025) as compared to mild OSA. The impacts of no OSA and mild OSA were similar (adjusted hazard ratio 1.07; 0.64-1.83, p=780).
Conclusions: Our findings support the current practice of focusing on M-S OSA as a negative prognostic factor for cardiovascular disease.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-350
- 2017 American College of Cardiology Foundation