Hsin-I Teng1, Chin-Chou Huang2, Chia-Hung Chiang3, Po-Hsun Huang4, Chia-Min Chung5, Shing-Jong Lin6, Jaw-Wen Chen2, Hsin-Bang Leu7, Wan-Leong Chan8, Chiu-Yang Lee9. 1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 2. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, ROC. 3. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC. 4. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 5. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, ROC. 6. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 7. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 8. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 9. Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. Electronic address: 2012cvman@gmail.com.
Abstract
BACKGROUND: Sleep apnea (SA) was associated with increased prevalence of aortic dissection (AD) in studies that were criticized for either their small sample size or lack of prospective observation. Using a considerably larger nationwide, population-based database and a long-term prospective cohort design, our study strived to explore the relationship between SA and the subsequent development of AD. METHODS: From 2000 to 2007, we gathered a study cohort consisting of 15,848 newly diagnosed cases of SA from Taiwan's National Health Insurance Research Database. For the control group, another 39,826 individuals without SA were matched for age, sex, and comorbidity. The two cohorts were followed-up to observe the occurrence of AD. RESULTS: During an average 3.59 ± 2.41 years of follow-up, we observed 33 cases of new AD occurrence [non-SA (22, 0.1%) vs. SA (11, 0.1%), p=0.669], and the incidence of AD was similar for both groups. After adjusting for age, sex, and comorbidity, only age [hazard ratio (HR) 1.03; 95% confidence interval (CI), 1.01-1.06; p=0.006], male gender (HR 2.49; 95% CI, 1.07-5.79; p=0.034), and hypertension (HR 6.28; 95% CI, 2.36-16.67; p<0.001) were independently associated with AD diagnosis. CONCLUSION: SA was not associated with an increased risk of AD using a large nationwide cohort database. Nonetheless, larger prospective studies or meta-analyses are recommended to confirm our findings.
BACKGROUND: Sleep apnea (SA) was associated with increased prevalence of aortic dissection (AD) in studies that were criticized for either their small sample size or lack of prospective observation. Using a considerably larger nationwide, population-based database and a long-term prospective cohort design, our study strived to explore the relationship between SA and the subsequent development of AD. METHODS: From 2000 to 2007, we gathered a study cohort consisting of 15,848 newly diagnosed cases of SA from Taiwan's National Health Insurance Research Database. For the control group, another 39,826 individuals without SA were matched for age, sex, and comorbidity. The two cohorts were followed-up to observe the occurrence of AD. RESULTS: During an average 3.59 ± 2.41 years of follow-up, we observed 33 cases of new AD occurrence [non-SA (22, 0.1%) vs. SA (11, 0.1%), p=0.669], and the incidence of AD was similar for both groups. After adjusting for age, sex, and comorbidity, only age [hazard ratio (HR) 1.03; 95% confidence interval (CI), 1.01-1.06; p=0.006], male gender (HR 2.49; 95% CI, 1.07-5.79; p=0.034), and hypertension (HR 6.28; 95% CI, 2.36-16.67; p<0.001) were independently associated with AD diagnosis. CONCLUSION: SA was not associated with an increased risk of AD using a large nationwide cohort database. Nonetheless, larger prospective studies or meta-analyses are recommended to confirm our findings.
Authors: Younghoon Kwon; Jeongok Logan; Susan Redline; Daniel Duprez; David R Jacobs; Pamela Ouyang; W Greg Hundley; Joao Lima; David A Bluemke; Pamela L Lutsey Journal: Cardiology Date: 2019-06-12 Impact factor: 1.869