title: Independent association between obstructive sleep apnea and noncalcified coronary plaque demonstrated by noninvasive coronary computed tomography angiography.
abstract: BACKGROUND
  Coronary artery atherosclerosis has been associated with obstructive sleep apnea (OSA). However, the type and severity of plaque formation have not been characterized. This study evaluated the association of coronary noncalcified plaques and severity of stenosis in patients with OSA.
  
  
  OBJECTIVE
  
  
  
  METHODS
  This study was a retrospective analysis of 81 patients, 49 with OSA and 32 without OSA, who had undergone multidetector-row helical computed tomography scanning. The board-certified radiologist was blinded to the diagnosis of OSA and reviewed the scans for plaque characterization, severity of stenosis, and number of vessels involved.
  
  
  RESULTS
  Of the 81 patients reviewed, the mean apnea-hypopnea index in the OSA group was 42.2 vs 7.5 in the non-OSA group. The groups did not significantly differ in the distribution of comorbid conditions. We found that among the patients with OSA, 63% had noncalcified/mixed plaques, as opposed to 16% in the non-OSA group (P < 0.0001), with unadjusted odds ratio of 9.3 (3.0, 28.4). After adjustment for other risk factors such as age, sex, race, hypercholesterolemia, and history of smoking, the association remained strong, with an odds ratio of 7.0 (1.9, 26.5; P < 0.05).
  
  
  CONCLUSIONS
  Our study finds that the frequency of noncalcified/mixed plaques is much higher in patients with OSA than in non-OSA patients. Patients with OSA also have more severe stenosis and a higher number of vessels involved. This study adds to a growing body of data regarding our understanding of the association of OSA and atherosclerosis.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, East Carolina University, Greenville, North Carolina, USA. sharmas@ecu.edu
authors.forename: Sunil
authors.initials: S
authors.lastname: Sharma
authors.forename: Mulugeta
authors.initials: M
authors.lastname: Gebregziabher
authors.forename: Adrian T
authors.initials: AT
authors.lastname: Parker
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Abro
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Armstrong
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
mesh_terms: D016001:Confidence Intervals; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology