Abstract 3851: Independent Association Between Subclinical Coronary Artery Disease and Obstructive Sleep Apnea
Background: Obstructive sleep apnea (OSA) causes repetitive hypoxemic episodes and sleep deprivation, increased sympathetic activity, endothelial dysfunction, metabolic abnormalities, and systemic inflammation. OSA is associated with coronary artery disease (CAD) risk factors, but it is unknown if OSA is itself associated with development of CAD. The present study aims to assess the association between OSA and the presence of subclinical CAD assessed by coronary artery calcification.
Materials and Methods: Consecutive patients with no history of CAD, who underwent an electron beam computed tomography within 3 years of polysomnography between March 1991 and December 2003, were included. OSA was defined as an apneahypopnea index (AHI) greater than 5, and patients were divided into quartiles of AHI severity. Multiple logistic regression modeled the association between the severity of OSA and presence of coronary artery calcification.
Results: There were 202 patients, 70% were male, median age was 50 years, mean body mass index was 33, 7% were diabetic, 9% were current smokers, 57% had dyslipidemia, and 44% had hypertension. OSA was present in 75%. Coronary artery calcification was present in 69% of OSA patients and 35% of non-OSA patients (p < 0.001). The mean coronary artery calcification score was 161 in OSA patients and 32 in non-OSA patients (p < 0.001).
Conclusions: In patients without clinical CAD, the presence and severity of OSA is independently associated with the presence and extent of coronary artery calcification. OSA identifies patients at risk for CAD and may represent a highly prevalent modifiable risk factor for CAD.