Obstructive sleep apnea associated with presence, burden of coronary plaque

A new study highlights an independent association between obstructive sleep apnea and coronary plaque presence and burden, suggesting it may be a risk factor for coronary events.

Researchers conducted a cross-sectional, single-center study that enrolled 692 adults (mean age, 55.1 years; 71% men) who underwent sleep monitoring and coronary CT angiography at Beijing Anzhen Hospital from September 2015 to April 2019. One hundred twenty patients (17.3%) underwent polysomnography and 572 (82.7%) underwent respiratory polygraphy.

Patients with moderate to severe OSA had a higher likelihood of the presence of coronary plaque (P = .037) and a higher likelihood for plaques to contain a noncalcified plaque component (P = .032) and a low-density noncalcified plaque component (P = .03), according to the researchers.

Both apnea-hypopnea index and oxygen desaturation index were associated with the presence of coronary plaque, a noncalcified plaque component and a low-density noncalcified plaque component (P < .05 for all), the researchers reported.

In multivariable linear regression models, moderate to severe OSA was also associated with noncalcified plaque volume (P = .042) and low-density noncalcified plaque volume (P = .011).

In addition, apnea-hypopnea index (P = .015), oxygen desaturation index (P = .005) and percentage of nighttime with oxygen saturation less than 90% (P = .017) were identified by the researchers as significant predictors of low-density noncalcified plaque volume.

When the researchers compared patients without OSA or with mild OSA, patients with severe OSA had higher total coronary plaque volume (P = .017), noncalcified plaque volume (P = .036) and low-density noncalcified plaque volume (P = .013).

“Our findings suggest an increased burden of high-risk plaques in patients with moderate to severe OSA, which may explain the increased risk of [acute coronary syndrome] in these patients,” Mi Lu, MD, from the department of otolaryngology and head and neck surgery at the Sleep Medical Center at Beijing Anzhen Hospital at Capital Medical University and The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases at the Beijing Institute of Heart, Lung and Blood Vessel Diseases, and colleagues wrote in Chest. “However, larger outcome studies are required to confirm this hypothesis.”