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Sleep Apnea-Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality

American journal of respiratory and critical care medicine, 2022-01, Vol.205 (1), p.108-117 [Peer Reviewed Journal]

Copyright American Thoracic Society Jan 1, 2022 ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 1073-449X ;EISSN: 1535-4970 ;DOI: 10.1164/rccm.202105-1274OC ;PMID: 34648724

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Title:
Sleep Apnea-Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality
Author: Trzepizur, Wojciech ; Blanchard, Margaux ; Ganem, Timothée ; Balusson, Frédéric ; Feuilloy, Mathieu ; Girault, Jean-Marc ; Meslier, Nicole ; Oger, Emmanuel ; Paris, Audrey ; Pigeanne, Thierry ; Racineux, Jean-Louis ; Sabil, AbdelKebir ; Gervès-Pinquié, Chloé ; Gagnadoux, Frédéric
Subjects: Adult ; Aged ; Biomarkers ; Cardiovascular disease ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cluster Analysis ; Databases, Factual ; Female ; Follow-Up Studies ; France - epidemiology ; Health risks ; Heart Disease Risk Factors ; Humans ; Hypoxia ; Hypoxia - complications ; Hypoxia - diagnosis ; Hypoxia - mortality ; Hypoxia - physiopathology ; Kaplan-Meier Estimate ; Life Sciences ; Male ; Middle Aged ; Mortality ; Patient Acuity ; Proportional Hazards Models ; Risk factors ; Sleep apnea ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - diagnosis ; Sleep Apnea, Obstructive - mortality ; Sleep Apnea, Obstructive - physiopathology
Is Part Of: American journal of respiratory and critical care medicine, 2022-01, Vol.205 (1), p.108-117
Description: Data from population-based cohorts suggest that symptom subtypes and obstructive sleep apnea (OSA)-specific hypoxic burden (HB) could help to better identify patients with OSA at high cardiovascular (CV) risk. We aimed to evaluate whether those new markers are associated with the risk of major adverse CV events (MACE) in clinical setting. Data from the Pays de la Loire cohort were linked to health administrative data to identify the occurrence of MACE (a composite outcome including all-cause mortality, acute myocardial infarction, stroke, and unplanned coronary revascularization) in patients with newly diagnosed OSA and no overt CV disease. Latent class analysis was used to identify subtypes based on eight clinically relevant variables. HB was defined as the total area under the respiratory event-related desaturation curve. Cox proportional hazards models were used to evaluate the association of symptom subtypes and HB with MACE. Four symptom subtypes were identified (minimally symptomatic [22.0%], disturbed sleep [17.5%], excessively sleepy [49.8%], and moderately sleepy [10.6%]). After a median follow-up of 78 months (interquartile range, 52-109), 592 (11.05%) of 5,358 patients experienced MACE. In a fully adjusted model, HB and overall nocturnal hypoxemia assessed by sleep time with oxygen saturation <90% were the only predictors of MACE (hazard ratio, 1.21; 95% confidence interval, 1.07-1.38; and hazard ratio, 1.34; 95% confidence interval, 1.16-1.55, respectively). The association appeared stronger toward younger patients and women. In clinical setting, patients with OSA who demonstrate elevated OSA-specific HB are at higher risk of a CV event and all-cause mortality. Symptom subtypes were not associated with MACE after adjustment for confounders.
Publisher: United States: American Thoracic Society
Language: English
Identifier: ISSN: 1073-449X
EISSN: 1535-4970
DOI: 10.1164/rccm.202105-1274OC
PMID: 34648724
Source: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection

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Sleep Apnea-Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality

Copyright American Thoracic Society Jan 1, 2022 ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 1073-449X ;EISSN: 1535-4970 ;DOI: 10.1164/rccm.202105-1274OC ;PMID: 34648724

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