Sleep and Breathing

, Volume 14, Issue 2, pp 131–136

Obstructive sleep apnea as a risk factor for coronary events or cardiovascular death

  • Neomi A. Shah
  • Henry Klar Yaggi
  • John Concato
  • Vahid Mohsenin
Original Article

DOI: 10.1007/s11325-009-0298-7

Cite this article as:
Shah, N.A., Yaggi, H.K., Concato, J. et al. Sleep Breath (2010) 14: 131. doi:10.1007/s11325-009-0298-7

Abstract

Purpose

This study aims to determine whether obstructive sleep apnea independently increases the risk of coronary events, including death from cardiovascular causes.

Methods

We conducted an observational cohort study among consecutive patients ≥50 years of age who were referred during 1997–2001 to the Yale Center for Sleep Medicine for suspected sleep-disordered breathing and were followed longitudinally for subsequent coronary events or cardiovascular death. Each study participant underwent an overnight polysomnography; obstructive sleep apnea was defined as an apnea–hypopnea index ≥5/h. The composite outcome during a mean duration of follow-up of 2.9 years was myocardial infarction, coronary artery revascularization procedures (angioplasty, stent placement, or coronary artery bypass graft surgery), or death from cardiovascular causes.

Results

Among 1,436 enrolled patients, 1,024 (71%) had an apnea–hypopnea index ≥5/h. In an unadjusted analysis, obstructive sleep apnea was associated with an increased risk of coronary events or cardiovascular death (hazard ration (HR) 2.57, 95% confidence interval (CI) 1.39–4.72, P = 0.003). After adjustment for traditional cardiovascular risk factors (including body mass index and hypertension), obstructive sleep apnea retained a statistically significant association with this composite outcome (HR 2.06, 95% CI 1.10–3.86, P = 0.024).

Conclusion

Obstructive sleep apnea increases the risk of coronary events or death from cardiovascular causes.

Keywords

Coronary artery diseaseCardiovascular diseaseObstructive sleep apneaSleep

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Neomi A. Shah
    • 1
    • 2
  • Henry Klar Yaggi
    • 1
    • 2
    • 4
  • John Concato
    • 3
    • 4
  • Vahid Mohsenin
    • 1
    • 2
  1. 1.Yale Center for Sleep MedicineNew HavenUSA
  2. 2.Section of Pulmonary and Critical Care MedicineYale University School of MedicineNew HavenUSA
  3. 3.General Internal MedicineYale University School of MedicineNew HavenUSA
  4. 4.Clinical Epidemiology Research CenterVeterans Affairs Connecticut Healthcare SystemWest HavenUSA