title: The diagnostic yield of exercise stress testing as a screening tool for subclinical coronary artery disease in patients with moderate to severe obstructive sleep apnea.
abstract: OBJECTIVE
  To address the yield of routine exercise stress testing as a screening tool for subclinical coronary artery disease (CAD) in patients with moderate to severe obstructive sleep apnea (OSA).
  
  
  METHODS
  A cross-sectional study in a university hospital.
  
  
  METHODS
  Of 380 consecutive patients with OSA, data from 206 subjects (mean apnea-hypopnea index [AHI] 41 ± 21 events/h) were studied; data from 78 with a history of CAD and 96 with mild OSA (AHI 5-15 events/h) were excluded.
  
  
  METHODS
  Routine exercise stress testing.
  
  
  RESULTS
  Six subjects could not reach maximal exercise capacity. Of the remaining 200 patients, the results of exercise stress testing were normal in 189. Three had a positive stress test, with coronary angiography confirming the diagnosis of CAD. Eight patients had suspected positive findings on the stress test, but the results of the myocardial perfusion study were negative.
  
  
  CONCLUSIONS
  The prevalence of subclinical CAD in this selected population with OSA was 1.5%, which is not higher than that in a general population. Our results do not support the routine use of exercise stress testing in patients with moderate to severe OSA who do not have symptoms of CAD.
authors.affiliation: Department of Respiratory Diseases, Akdeniz University Hospital, Antalya, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Cilli
authors.forename: Fulsen
authors.initials: F
authors.lastname: Batmaz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Demir
authors.forename: Adil
authors.initials: A
authors.lastname: Boz
authors.forename: Evren
authors.initials: E
authors.lastname: Toprak
authors.forename: Tülay
authors.initials: T
authors.lastname: Ozdemir
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Peker
mesh_terms: D000328:Adult; D017677:Age Distribution; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*