Atherosclerotic plaque in individuals without known cardiovascular disease but with established obstructive sleep apnea and at high risk of obstructive sleep apnea.
Atherosclerotic plaque in individuals without known cardiovascular disease but with established obstructive sleep apnea and at high risk of obstructive sleep apnea.
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DOI：
10.1016/j.ajpc.2023.100497
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发表时间：
2023-06
影响因子：
4.1
通讯作者：
Nasir, Khurram
中科院分区：
文献类型：
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作者：
Walia, Harneet K;Khosla, Atulya Aman;Saxena, Anshul;Aneni, Ehimen;Ali, Shozab S;Valero-Elizondo, Javier;Cainzos-Achirica, Miguel;Feldman, Theodore;Fialkow, Jonathan;Nasir, Khurram
在一个通过冠状动脉计算机CT血管造影评估的无CVD的大型美国队列中，我们旨在评估阻塞性睡眠呼吸暂停（OSA）的既定/高风险与冠状动脉斑块之间的相关性。在无CVD的人群样本中，描述OSA的既定/高风险与冠状动脉斑块存在之间的相关性的数据有限。本研究使用了参加迈阿密心脏研究（MiHeart）并接受冠状动脉CT血管造影的2359名参与者的横截面数据。采用柏林问卷对患者进行OSA高风险或低风险分层。进行多变量logistic回归分析，以研究发生OSA的风险与斑块的存在、体积和组成之间的关系。根据柏林问卷，1559名参与者（66.1%）为OSA低风险，800名患者（33.9%）为OSA高风险。CCTA上的斑块表征显示，与低风险OSA队列相比，已确定/高风险OSA类别中任何可能的斑块组成的发生率更高（59.6% vs. 43.5%）。在logistic回归模型中，在调整人口统计学和心血管风险因素后，在CCTA上的任何冠状动脉斑块与OSA的已建立/高风险之间仍然存在显著相关性（OR=1.31，CI 1.05，1.63，p = 0.016）。西班牙裔人群的亚组分析也显示了OSA的既定/高风险与CCTA上冠状动脉斑块的存在之间的显著相关性（OR = 1.55 CI 1.13，2.12，p = 0.007）。在考虑了CVD风险因素后，具有OSA的确定/高风险的个体具有更高的冠状动脉斑块存在的可能性。未来的研究应该集中在阻塞性睡眠呼吸暂停的存在或风险，阻塞性睡眠呼吸暂停的严重程度，冠状动脉粥样硬化的纵向后果。
In a large U.S. cohort free of CVD evaluated by coronary computed CT angiography, we aimed to assess the association between established / high risk of Obstructive Sleep Apnea (OSA) and coronary plaque. There are limited data available depicting the association between established / high risk of OSA and the presence of coronary plaque in a population-based sample free from CVD. Cross-sectional data from 2359 participants enrolled in the Miami Heart Study (MiHeart) who underwent coronary CT angiography was used for this study. The Berlin questionnaire was used to stratify patients as having high or low risk of OSA. Multiple multivariable logistic regression analyses were conducted to investigate the association between the risk of developing OSA with the presence, volume, and composition of plaque. According to the Berlin questionnaire, 1559 participants were (66.1%) at low risk of OSA and 800 patients (33.9%) with established / high risk of OSA. Plaque characterization on CCTA revealed a greater incidence of any possible plaque composition in the established / high risk of OSA category (59.6% vs. 43.5%) compared to the low risk of OSA cohort. In logistic regression models, after adjusting for demographics and cardiovascular risk factors, a significant association could still be noted between established / high risk of OSA and any coronary plaque on CCTA (OR=1.31, CI 1.05, 1.63, p = 0.016). Subgroup analysis in the Hispanic population also portrayed a significant association between established / high risk of OSA and the presence of coronary plaque on CCTA (OR = 1.55 CI 1.13, 2.12, p = 0.007). After accounting for CVD risk factors, individuals at established / high risk of OSA have a higher likelihood of the presence of coronary plaque. Future studies should focus on OSA presence or risk, OSA severity, and the longitudinal consequences of coronary atherosclerosis.
影响因子：
6.5
作者：
Tuleta, Izabela;Pabst, Stefan;Juergens, Uwe R;Nickenig, Georg;Skowasch, Dirk
通讯作者：
Skowasch, Dirk