Raphael Le Mao1,2, David Jiménez3,4,5, Behnood Bikdeli6,7,8, Mateo Porres-Aguilar9, Alberto García-Ortega10, Vladimir Rosa11, Sebastian Schellong12, Lucia Mazzolai13, Francisco Rivera-Civico14, Manuel Monreal5,15,16. 1. Département de Médecine Vasculaire, Interne et Pneumologie, EA3878, Groupe d'Etude de la Thrombose de Bretagne Occidentale, Centre hospitalo-universitaire de Brest, Université de Bretagne Occidentale, Brest, France. 2. Centre d'Investigation Clinique INSERM 1412, Brest, France. 3. Respiratory Department, Hospital Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. 4. Department of Medicine, Universidad de Alcalá, (IRYCIS), Madrid, Spain. 5. CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain. 6. Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States. 7. Center for Outcomes Research and Evaluation (CORE), Yale University School of Medicine, New Haven, Connecticut, United States. 8. Cardiovascular Research Foundation, New York, New York, United States. 9. Adult Thrombosis Medicine, Centre of Excellence in Thrombosis and Anticoagulation Care (CETAC), Jewish General Hospital, Department of Medicine, McGill University, Montreal, Quebec, Canada. 10. Department of Respiratory Medicine, Hospital La Fe, Valencia, Spain. 11. Department of Internal Medicine. Hospital Universitario Virgen de Arrixaca, Murcia, Spain. 12. Department of Medical Clinic, Municipal Hospital of Dresden Friedrichstadt, Dresden, Germany. 13. Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. 14. Department of Internal Medicine, Hospital de Poniente, El Ejido, Almeria, Spain. 15. Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. 16. Department of Medicine, Universidad Católica de Murcia, Murcia, Spain.
Abstract
BACKGROUND: In patients with pulmonary embolism (PE), there is a lack of comprehensive data on the prevalence and prognostic significance of pre-existing obstructive sleep apnea (OSA). METHODS: In this study of patients with PE from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry, we assessed the prevalence of OSA, and the association between pre-existing OSA and the outcomes of all-cause mortality, PE-related mortality, recurrences, and major bleeding over 30 days after initiation of PE treatment. Additionally, we also examined rates of outcomes within 90 days and 1 year following the diagnosis of PE. RESULTS: Of 4,153 patients diagnosed with PE, 241 (5.8%; 95% confidence interval [CI]: 5.1-6.6%) had pre-existing OSA. Overall, 166 (4.0%; 95% CI: 3.4-4.6%) died during the first 30 days of follow-up. In multivariable analysis, the OSA syndrome was not a significant predictor of death from any cause (odds ratio [OR]: 1.5; 95% CI: 0.8-2.9; p = 0.19). However, patients with pre-existing OSA had an increased PE-specific mortality (adjusted OR: 3.0; 95% CI: 1.3-6.8; p = 0.01) compared with those without OSA. OSA was not significantly associated with 30-day recurrent venous thromboembolism (adjusted OR: 0.6; 95% CI: 0.1-4.7; p = 0.65) or major bleeds (adjusted OR: 1.0; 95% CI: 0.4-2.2; p = 1.0). Findings were similar at 90-day and 1-year follow-ups. CONCLUSION: In patients presenting with PE, pre-existing OSA is relatively infrequent. Patients with OSA were at increased risk of PE-related mortality when compared with those without OSA. Thieme. All rights reserved.
BACKGROUND: In patients with pulmonary embolism (PE), there is a lack of comprehensive data on the prevalence and prognostic significance of pre-existing obstructive sleep apnea (OSA). METHODS: In this study of patients with PE from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry, we assessed the prevalence of OSA, and the association between pre-existing OSA and the outcomes of all-cause mortality, PE-related mortality, recurrences, and major bleeding over 30 days after initiation of PE treatment. Additionally, we also examined rates of outcomes within 90 days and 1 year following the diagnosis of PE. RESULTS: Of 4,153 patients diagnosed with PE, 241 (5.8%; 95% confidence interval [CI]: 5.1-6.6%) had pre-existing OSA. Overall, 166 (4.0%; 95% CI: 3.4-4.6%) died during the first 30 days of follow-up. In multivariable analysis, the OSA syndrome was not a significant predictor of death from any cause (odds ratio [OR]: 1.5; 95% CI: 0.8-2.9; p = 0.19). However, patients with pre-existing OSA had an increased PE-specific mortality (adjusted OR: 3.0; 95% CI: 1.3-6.8; p = 0.01) compared with those without OSA. OSA was not significantly associated with 30-day recurrent venous thromboembolism (adjusted OR: 0.6; 95% CI: 0.1-4.7; p = 0.65) or major bleeds (adjusted OR: 1.0; 95% CI: 0.4-2.2; p = 1.0). Findings were similar at 90-day and 1-year follow-ups. CONCLUSION: In patients presenting with PE, pre-existing OSA is relatively infrequent. Patients with OSA were at increased risk of PE-related mortality when compared with those without OSA. Thieme. All rights reserved.
Authors: Rodrigo Jiménez-García; Ana López-de-Andrés; Javier de-Miguel-Diez; Marta Lopez-Herranz; Valentín Hernandez-Barrera; David Jimenez; Manuel Monreal Journal: Sci Rep Date: 2021-09-15 Impact factor: 4.379