Independent Association Between Obstructive Sleep Apnea And Coronary Artery Calcification

Objective: Obstructive sleep apnea(OSA)is associated with coronary risk factors,but it does not known if OSA is associated with development of coronary disease.We evaluated the association between OSA and coronary artery calcification(CAC).Methods: Consecutive patients with no history of coronary disease,who underwent computed tomography within 3 years of polysomnography between August 2015 and December 2018,were included.OSA was defined by an apnea-hypopnea index(AHI)? 5,and patients were grouped by quartiles of AHI severity.Logistic regression modeled the association between OSA severity and presence of CAC.Results: There were 68 patients(69% male,median age 49,mean body mass index 31.5,7% diabetic,8% current smokers,58% hypercholesterolemic,and 46% hypertensive).OSA was present in 67.6%.CAC was present in 69% of OSA patients and 33% of non-OSA patients(p<0.001).The median CAC score(Agatston Units)was 8 in OSA patients and 0 in non-OSA patients(p<0.001).The median CAC score was higher as OSA severity increased(p for trend by AHI quartile<0.001).With multivariate adjustment,the odds ratio for CAC increased with OSA severity.Using the first AHI quartile as reference,the adjusted odds ratio for the second,third,and fourth quartiles were 2.1(p=0.11),2.4(p=0.07),and 3.2(p=0.03)respectively.Conclusions: The presence and severity of CAC were independently correlated with the presence and extent of CAC in patients with CAC but without clinically diagnosed coronary heart disease.OSA can reflect a patient's risk of coronary heart disease to some extent.