Obstructive sleep apnea as a risk factor for coronary events or cardiovascular death.
OBJECTIVE
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 >or=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 >or=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 >or=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).


CONCLUSIONS
Obstructive sleep apnea increases the risk of coronary events or death from cardiovascular causes.
Yale Center for Sleep Medicine, New Haven, CT, USA.
Neomi A
NA
Shah
Henry Klar
HK
Yaggi
John
J
Concato
Vahid
V
Mohsenin
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality*; D017286:Polysomnography; D016016:Proportional Hazards Models; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D015607:Stents