title: Effect of CPAP treatment on plasma high sensitivity troponin levels in patients with obstructive sleep apnea.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is associated with an increased prevalence of cardiovascular diseases. New generations of highly sensitive assays for cardiac troponin (hs-cTnT) have been introduced recently, and a number of clinical observations have challenged the notion that troponins are only increased in blood following irreversible necrosis.
  
  
  OBJECTIVE
  The aims of this study were to compare the levels of hs-cTnT between a group of healthy controls and a group of patients with OSA without co-existent coronary artery disease, and to assess the possible influence of the treatment with Continuous positive airway pressure (CPAP) on these levels.
  
  
  METHODS
  The study population included 200 male participants. The case (n = 133) or control (n = 67) status was defined by an apnea-hypopnea index of 10 or greater. The hs-cTnT assay was validated as reported previously, with a limit of detection of 3 ng/L and an upper reference limit (99th percentile) of 14 ng/L.
  
  
  RESULTS
  The proportion of subjects with detectable plasma hs-cTnT was higher in patients with OSA than in controls (61 vs 75%, p = 0.04). In patients, a significant increase in hs-cTnT levels was observed after an effective treatment with CPAP (7.3 ± 3.4 vs 10.1 ± 4.9 ng/L; p < 0.01).
  
  
  CONCLUSIONS
  This study shows that the percentage of subjects with detectable hs-cTnT is associated with the presence of OSA. It also evidences that treatment with CPAP is followed by a rise in hs-cTnT concentrations. It is reasonable to suggest that CPAP therapy might induce a potential degree of cardiac stress, resulting in deleterious consequences for the heart.
authors.affiliation: Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: antonia.barcelo@ssib.es.
authors.forename: Antonia
authors.initials: A
authors.lastname: Barceló
authors.affiliation: Servei de Pneumologia, Hospital Arnau de Vilanova, IRB Lleida, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Esquinas
authors.affiliation: Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Josep Miquel
authors.initials: JM
authors.lastname: Bauçà
authors.affiliation: Unitat d'Investigació, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Piérola
authors.affiliation: Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: de la Peña
authors.affiliation: Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Arqué
authors.affiliation: Servei de Pneumologia, Hospital Arnau de Vilanova, IRB Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sánchez-de-la-Torre
authors.affiliation: Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alonso-Fernández
authors.affiliation: Servei de Pneumologia, Hospital Arnau de Vilanova, IRB Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000628:therapy*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: CPAP; Cardiac biomarker; Sleep apnea; Sleep disordered breathing; Troponin; hs-cTnT