David J Murphy1, Sophie J Crinion2, Ciaran E Redmond3, Gerard M Healy4, Walter T McNicholas5, Silke Ryan6, Jonathan D Dodd7. 1. Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: dmurphy23@partners.org. 2. Pulmonary and Sleep Disorders Unit, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: s.kerrcrinion@st-vincents.ie. 3. Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: ciaran.redmond@svuh.ie. 4. Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: ger.healy@svuh.ie. 5. Pulmonary and Sleep Disorders Unit, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland. Electronic address: walter.mcnicholas@ucd.ie. 6. Pulmonary and Sleep Disorders Unit, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland. Electronic address: s.ryan@st-vincents.ie. 7. Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland. Electronic address: j.dodd@st-vincents.ie.
Abstract
AIM: To assess the diagnostic accuracy of common carotid artery intima media thickness (CIMT) for coronary artery disease (CAD) detection in patients with obstructive sleep apnoea (OSA). MATERIALS & METHODS: Patients with clinically suspected OSA prospectively underwent polysomnography (PSG), ultrasound CIMT measurement and coronary computed tomography angiography (CTA). An average CIMT of ≥0.9 mm in either common carotid artery designated as a positive test. Coronary CTA was the reference standard for the presence of CAD. Coronary plaque presence, volume, density and type were correlated with CIMT findings. RESULTS: 35 consecutive male patients were enrolled from sleep clinic. Two patients had no evidence of OSA on PSG (apnoea-hypopnea index [AHI]<5/hr), and were excluded. Of the remaining 33, 18 (54%) had mild-moderate OSA (AHI 5-30/hr) and 15 (46%) had severe OSA (AHI >30/hr). Eight (24%) patients had CAD on coronary CTA. Coronary plaques were predominantly non- or partly calcified, and located in proximal coronary artery segments. Sensitivity, specificity, positive and negative predictive and likelihood ratios for a positive CIMT (≥0.9 mm) in diagnosing CAD were 0.5 (95% confidence interval: 0.76-0.12), 0.96 (1-0.89), 80, 85.7, 12.5 and 0.52 respectively. The adjusted odds ratio was 40.8. CONCLUSION: In patients with OSA, CIMT is a highly specific but poorly sensitive test for detecting CAD.
AIM: To assess the diagnostic accuracy of common carotid artery intima media thickness (CIMT) for coronary artery disease (CAD) detection in patients with obstructive sleep apnoea (OSA). MATERIALS & METHODS:Patients with clinically suspected OSA prospectively underwent polysomnography (PSG), ultrasound CIMT measurement and coronary computed tomography angiography (CTA). An average CIMT of ≥0.9 mm in either common carotid artery designated as a positive test. Coronary CTA was the reference standard for the presence of CAD. Coronary plaque presence, volume, density and type were correlated with CIMT findings. RESULTS: 35 consecutive male patients were enrolled from sleep clinic. Two patients had no evidence of OSA on PSG (apnoea-hypopnea index [AHI]<5/hr), and were excluded. Of the remaining 33, 18 (54%) had mild-moderate OSA (AHI 5-30/hr) and 15 (46%) had severe OSA (AHI >30/hr). Eight (24%) patients had CAD on coronary CTA. Coronary plaques were predominantly non- or partly calcified, and located in proximal coronary artery segments. Sensitivity, specificity, positive and negative predictive and likelihood ratios for a positive CIMT (≥0.9 mm) in diagnosing CAD were 0.5 (95% confidence interval: 0.76-0.12), 0.96 (1-0.89), 80, 85.7, 12.5 and 0.52 respectively. The adjusted odds ratio was 40.8. CONCLUSION: In patients with OSA, CIMT is a highly specific but poorly sensitive test for detecting CAD.
Authors: Visula Abeysuriya; Nirmala A I Wijesinha; Prakash P Priyadharshan; Lal G Chandrasena; Ananda Rajitha Wickremasinghe Journal: PLoS One Date: 2022-08-22 Impact factor: 3.752