title: Familial premature coronary artery disease mortality and obstructive sleep apnea.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is linked to both coronary artery disease (CAD) and sudden death, but any causal role remains unclear. A family history of premature CAD and related mortality is an independent risk factor for the development of CAD. We hypothesized that OSA is associated with a family history of premature mortality from ischemic heart disease.
  
  
  METHODS
  We prospectively studied 588 subjects who underwent polysomnography from May 2000 to June 2004. Demographics, comorbidities, family history of cardiovascular disease, and the ages and causes of death for 10 strata of family members were recorded for all subjects. We excluded those subjects with known causes of premature cardiac death, such as hypertrophic cardiomyopathy and long-QT syndrome. OSA was defined by American Academy of Sleep Medicine criteria (ie, apnea-hypopnea index >or= 5). Premature CAD mortality was defined as death due to ischemic heart disease or sudden cardiac death before 55 years of age (men) or 65 years of age (women).
  
  
  RESULTS
  Polysomnography confirmed OSA in 316 subjects and excluded it in 202 subjects. The unadjusted odds ratio (OR) for OSA and a family history of premature CAD mortality was 2.11 (95% confidence interval [CI], 1.10 to 4.31; p = 0.031). After adjusting for each subject's sex, body mass index, and history of CAD, there was a significant and independent association between OSA and family history of premature CAD mortality (OR, 2.13; 95% CI, 1.04 to 4.66; p = 0.046).
  
  
  CONCLUSIONS
  Regardless of their own CAD status, people with OSA are more likely than those without OSA to have a family history of premature CAD mortality.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
authors.forename: Apoor S
authors.initials: AS
authors.lastname: Gami
authors.forename: Stefanie
authors.initials: S
authors.lastname: Rader
authors.forename: Anna
authors.initials: A
authors.lastname: Svatikova
authors.forename: Robert
authors.initials: R
authors.lastname: Wolk
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Herold
authors.forename: Christine
authors.initials: C
authors.lastname: Huyber
authors.forename: Mikolaj
authors.initials: M
authors.lastname: Winnicki
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
mesh_terms: D002423:Cause of Death; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications* / Q000235:genetics* / Q000401:mortality*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis