Abstract 10185: Coronary Vasomotor Dysfunction in Patients with Obstructive Sleep Apnea
Introduction: Obstructive sleep apnea (OSA) has been associated with increased risk of cardiovascular events which might be mediated by coronary vasomotor dysfunction (CVD). The current study evaluates the association between CVD and OSA in patients with non-obstructive coronary atherosclerosis.
Methods: All patients who had both a polysomnogram as well as an invasive coronary vasomotor study at the Mayo Clinic, Rochester MN from 1997–2009 were identified (n=108). OSA was defined as an apnea-hypoxia index of ≥5. Four endpoints of CVD — % change in coronary artery diameter (CAD) at the mid and distal-LAD, % change in coronary blood flow (CBF) to intracoronary acetylcholine, and maximum coronary flow reserve ratio (CFR) to intracoronary adenosine were specified. We tested for a difference in CVD endpoints between patients with OSA (n=73) and without OSA (n=35) with multivariate analysis of variance using Wilks' Lambda statistic.
Results: Patients with OSA were older and more likely to have hypertension or use beta-blockers compared to patients without OSA, but less likely to have depression (Table). OSA was not associated with CVD (p=0.28) (Figure) even after adjustment for differences between the groups (p=0.22). Similarly, CVD was not associated with patients who had oxygen desaturations to <90% during polysomnography (p=0.63). There was no difference in interaction between sexes.
Conclusions: The current study suggests that OSA is not associated with CVD in patients with early coronary atherosclerosis. The adverse coronary outcomes in patients with OSA may be independent of CVD and the assessment for both conditions may add to risk stratification of coronary artery disease.
- © 2010 by American Heart Association, Inc.