title: OSA and coronary plaque characteristics.
abstract: BACKGROUND
  Virtual histology intravascular ultrasound (VH-IVUS) is an intravascular imaging technique that enables the characterization of coronary plaques. We sought to determine the association between OSA and coronary plaque characteristics in patients presenting with coronary artery disease.
  
  
  METHODS
  We prospectively recruited patients with angiographically proven coronary artery disease for a VH-IVUS examination and home-based sleep study. The total atheroma volume of the entire target coronary artery and the incidence of thin cap fibroatheroma of patients with no to mild and moderate to severe OSA were compared.
  
  
  RESULTS
  One hundred eighteen patients were recruited from two university-affiliated centers. Among the 93 patients who completed the study, 32 (34.4%) had newly diagnosed moderate to severe OSA (apnea-hypopnea index > 15). Compared with patients with no to mild OSA, those with moderate to severe OSA had a larger total atheroma volume (461.3 ± 250.4 mm³ vs 299.2 ± 135.6 mm³, P < .001), and the association remained after adjustment for age, BMI, hypertension, diabetes mellitus, smoking, and hyperlipidemia (relative mean difference, 1.73; 95% CI, 1.38-2.15). In contrast, there were no significant differences between the patients with moderate to severe OSA and no to mild OSA regarding the prevalence of thin cap fibroatheroma in the culprit lesion (53.1% vs 54.2%, P = .919).
  
  
  CONCLUSIONS
  In patients presenting with coronary artery disease, moderate to severe OSA was independently associated with a larger total atheroma volume in the target coronary artery. Further studies on the effects of CPAP on total atheroma volume are warranted.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT01306526; URL: www.clinicaltrials.gov.
authors.affiliation: Division of Respiratory Medicine, University Medical Cluster, National University Health System.
authors.forename: Adeline
authors.initials: A
authors.lastname: Tan
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.
authors.forename: William
authors.initials: W
authors.lastname: Hau
authors.affiliation: Division of Respiratory Medicine, University Medical Cluster, National University Health System; Department of Cardiology, Tan Tock Seng Hospital.
authors.forename: Hee-Hwa
authors.initials: HH
authors.lastname: Ho
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System.
authors.forename: Haleh
authors.initials: H
authors.lastname: Ghaem Maralani
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.
authors.forename: Germaine
authors.initials: G
authors.lastname: Loo
authors.affiliation: Division of Respiratory Medicine, University Medical Cluster, National University Health System.
authors.forename: See-Meng
authors.initials: SM
authors.lastname: Khoo
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System.
authors.forename: Bee-Choo
authors.initials: BC
authors.lastname: Tai
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Cardiology, National University Heart Centre, Singapore.
authors.forename: A Mark
authors.initials: AM
authors.lastname: Richards
authors.affiliation: Division of Respiratory Medicine, University Medical Cluster, National University Health System; Department of Cardiology, Tan Tock Seng Hospital.
authors.forename: Paul
authors.initials: P
authors.lastname: Ong
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital; Department of Cardiology, National University Heart Centre, Singapore. Electronic address: mdclchr@nus.edu.sg.
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
mesh_terms: D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D018084:Ultrasonography, Interventional