Obstructive sleep apnea as a risk factor for coronary events or cardiovascular death
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This study aims to determine whether obstructive sleep apnea independently increases the risk of coronary events, including death from cardiovascular causes.
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.
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).
Obstructive sleep apnea increases the risk of coronary events or death from cardiovascular causes.
KeywordsCoronary artery disease Cardiovascular disease Obstructive sleep apnea Sleep
Sources of support
National Research Service Award Institutional Research Training Grant from the National Institutes of Health (T32 HL00778-12), Yale Center for Sleep Medicine, Career Development Award from the Veterans Affairs Health Services Research and Development Service
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