0719 The Association of Sleep Apnea and Cardiorespiratory Fitness with Long-Term Major Cardiovascular Events

Autor:	Sean M. Caples, Francisco Lopez-Jimenez, Maria Irene Barillas-Lara, Thomas P. Olson, Amanda R. Bonikowske, Thomas G. Allison, B Kolla, Joshua R. Smith, Jose R. Medina-Inojosa, Meghna P. Mansukhani, Virend K. Somers
Rok vydání:	2020
Předmět:	medicine.medical_specialty business.industry Sleep apnea Cardiorespiratory fitness medicine.disease Term (time) Physiology (medical) Internal medicine medicine Cardiology cardiovascular diseases Neurology (clinical) Association (psychology) business
Zdroj:	Sleep. 43:A273-A274
ISSN:	1550-9109 0161-8105
DOI:	10.1093/sleep/zsaa056.715
Popis:	Introduction Sleep disordered breathing (SDB) is associated with adverse cardiovascular outcomes and decreased cardiorespiratory fitness (CRF). The risk of long-term major adverse cardiovascular events (MACE) when SDB and decreased CRF co-occur has not been determined. Methods We included consecutive patients that underwent a symptom-limited cardiopulmonary exercise test followed by first-time diagnostic polysomnography within 6 months. Patients were stratified based on the presence of moderate-severe SDB (apnea/hypopnea index ≥15/hour) and decreased CRF defined as Results Of 498 included patients (60±13 years, 28.1% female), 175 (35%) had MACE (MI=17, PCI=14, CABG=13, stroke=20, TIA=12, deaths=99) at a median follow-up of 8.7 years (interquartile range=6.5-10.3 years). After adjusting for age, sex, beta-blockers, systemic hypertension, diabetes mellitus, coronary artery disease, cardiac arrhythmia, chronic obstructive pulmonary disease, smoking and positive airway pressure (PAP) usage, decreased CRF alone (HR=1.91, 95%CI=1.15-3.18, p=0.012), but not SDB alone (HR=1.26, 95%CI=0.75-2.13, p=0.389) was associated with increased risk of MACE. Those with SDB and decreased CRF had increased risk of MACE compared to patients with decreased CRF alone (HR=1.85, 95%CI=1.21-2.84, p Conclusion The incidence of MACE, including mortality, was high in this sample. Moderate-severe SDB with concurrent decreased CRF was associated with higher risk of MACE than decreased CRF alone. These results highlight the importance of including CRF in the risk assessment of patients with SDB, and conversely, that of screening for SDB in patients with low peak VO2. Support None.
Databáze:	OpenAIRE
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