Adeline Tan1, William Hau2, Hee-Hwa Ho3, Haleh Ghaem Maralani4, Germaine Loo2, See-Meng Khoo1, Bee-Choo Tai4, A Mark Richards5, Paul Ong3, Chi-Hang Lee6. 1. Division of Respiratory Medicine, University Medical Cluster, National University Health System. 2. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore. 3. Division of Respiratory Medicine, University Medical Cluster, National University Health System; Department of Cardiology, Tan Tock Seng Hospital. 4. Saw Swee Hock School of Public Health, National University of Singapore, National University Health System. 5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Cardiology, National University Heart Centre, Singapore. 6. Department of Cardiology, Tan Tock Seng Hospital; Department of Cardiology, National University Heart Centre, Singapore. Electronic address: mdclchr@nus.edu.sg.
Abstract
BACKGROUND: Virtual histology intravascular ultrasound (VH-IVUS) is an intravascular imaging technique that enables the characterization of coronary plaques. We sought to determine the association between OSA and coronary plaque characteristics in patients presenting with coronary artery disease. METHODS: We prospectively recruited patients with angiographically proven coronary artery disease for a VH-IVUS examination and home-based sleep study. The total atheroma volume of the entire target coronary artery and the incidence of thin cap fibroatheroma of patients with no to mild and moderate to severe OSA were compared. RESULTS: One hundred eighteen patients were recruited from two university-affiliated centers. Among the 93 patients who completed the study, 32 (34.4%) had newly diagnosed moderate to severe OSA (apnea-hypopnea index > 15). Compared with patients with no to mild OSA, those with moderate to severe OSA had a larger total atheroma volume (461.3 ± 250.4 mm³ vs 299.2 ± 135.6 mm³, P < .001), and the association remained after adjustment for age, BMI, hypertension, diabetes mellitus, smoking, and hyperlipidemia (relative mean difference, 1.73; 95% CI, 1.38-2.15). In contrast, there were no significant differences between the patients with moderate to severe OSA and no to mild OSA regarding the prevalence of thin cap fibroatheroma in the culprit lesion (53.1% vs 54.2%, P = .919). CONCLUSIONS: In patients presenting with coronary artery disease, moderate to severe OSA was independently associated with a larger total atheroma volume in the target coronary artery. Further studies on the effects of CPAP on total atheroma volume are warranted. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01306526; URL: www.clinicaltrials.gov.
BACKGROUND: Virtual histology intravascular ultrasound (VH-IVUS) is an intravascular imaging technique that enables the characterization of coronary plaques. We sought to determine the association between OSA and coronary plaque characteristics in patients presenting with coronary artery disease. METHODS: We prospectively recruited patients with angiographically proven coronary artery disease for a VH-IVUS examination and home-based sleep study. The total atheroma volume of the entire target coronary artery and the incidence of thin cap fibroatheroma of patients with no to mild and moderate to severe OSA were compared. RESULTS: One hundred eighteen patients were recruited from two university-affiliated centers. Among the 93 patients who completed the study, 32 (34.4%) had newly diagnosed moderate to severe OSA (apnea-hypopnea index > 15). Compared with patients with no to mild OSA, those with moderate to severe OSA had a larger total atheroma volume (461.3 ± 250.4 mm³ vs 299.2 ± 135.6 mm³, P < .001), and the association remained after adjustment for age, BMI, hypertension, diabetes mellitus, smoking, and hyperlipidemia (relative mean difference, 1.73; 95% CI, 1.38-2.15). In contrast, there were no significant differences between the patients with moderate to severe OSA and no to mild OSA regarding the prevalence of thin cap fibroatheroma in the culprit lesion (53.1% vs 54.2%, P = .919). CONCLUSIONS: In patients presenting with coronary artery disease, moderate to severe OSA was independently associated with a larger total atheroma volume in the target coronary artery. Further studies on the effects of CPAP on total atheroma volume are warranted. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01306526; URL: www.clinicaltrials.gov.
Authors: Neomi Shah; Matthew Allison; Yanping Teng; Sylvia Wassertheil-Smoller; Daniela Sotres-Alvarez; Alberto R Ramos; Phyllis C Zee; Michael H Criqui; Henry K Yaggi; Linda C Gallo; Susan Redline; Robert C Kaplan Journal: Arterioscler Thromb Vasc Biol Date: 2015-02-05 Impact factor: 8.311