Abstract MP67: Objectively Measured Sleep Characteristics and Prevalence of Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis Sleep Study
Background: It is unclear whether objectively measured obstructive sleep apnea (OSA) and other abnormal sleep phenotypes are associated with coronary artery calcification (CAC) prevalence independent of obesity, a classic confounder. We tested that hypothesis, and also examined possible mediation by cardiovascular risk factors.
Methods: A total of 1,465 Multi-Ethnic Study of Atherosclerosis participants [mean age 68 years] had both coronary CT and in-home polysomnography and actigraphy. OSA categories were defined by apnea-hypopnea index (AHI). Other sleep phenotypes included measures of sleep stages, fragmentation and duration. Prevalence ratios for CAC >0 and >400 (high burden) were calculated.
Results: Participants with severe OSA (AHI ≥30; 14.6%) were more likely to have prevalent CAC, relative to those with no evidence of OSA, after adjustment for demographics and smoking status [1.16 (95% CI: 1.06-1.26)], body mass index [1.11 (1.02-1.21)], and traditional cardiovascular risk factors [1.10 (1.01-1.19)]. Other markers of hypoxia tended to be associated with higher prevalence of CAC >0, while markers of sleep architecture, fragmentation and duration were not. For CAC >400 a higher prevalence was observed with both a higher arousal index and less slow-wave sleep. Overall, associations were somewhat stronger among younger participants, but there was no evidence of interaction by sex or race/ethnicity.
Conclusions: Subclinical coronary artery disease, measured by CAC >0, was more prevalent among participants with OSA, independent of obesity and traditional cardiovascular risk factors, relative to participants with no OSA. These findings support recent evidence suggesting that OSA is associated with risk of incident coronary artery disease.
Author Disclosures: P.L. Lutsey: None. R.L. McClelland: None. D. Duprez: None. S. Shea: None. E. Shahar: None. M. Nagayoshi: None. M. Budoff: None. J.D. Kaufman: None. S. Redline: None.
- © 2015 by American Heart Association, Inc.