Is acute pulmonary embolism more severe in the presence of obstructive sleep apnea? Results from an observational cohort study

Konnerth, Dinah; Schwarz, Florian; Probst, Michael; Seidler, Martin; Wagner, Tanja; Faul, Christian; Scheidt, Wolfgang von; Schwaiblmair, Martin und Berghaus, Thomas M. (2018): Is acute pulmonary embolism more severe in the presence of obstructive sleep apnea? Results from an observational cohort study. In: Journal of Thrombosis and Thrombolysis, Bd. 46, Nr. 2: S. 253-259

Abstract

Obstructive sleep apnea (OSA) might influence disease severity in acute pulmonary embolism (PE). 253 survivors of acute PE were evaluated for sleep-disordered breathing by portable monitoring and nocturnal polysomnography. PE patients with an apnea-hypopnoea index (AHI) ae 15/h were significantly older (p < 0.001), had significantly impaired renal (p < 0.001) and left ventricular functions (p = 0.003), showed significantly elevated troponin I (p = 0.005) and D-dimer levels (p = 0.024), were hospitalised significantly longer (p < 0.001), and had significantly elevated PE severity scores (p = 0.015). Moderate or severe OSA was significantly (p = 0.006) more frequent among intermediate- and high-risk PE patients (81.0%) compared to the low-risk PE cohort (16.3%). Multiple logistic regression analysis revealed that PE patients in the AHI ae 15/h cohort were at significant risk for myocardial injury (p = 0.015). Based on clinical risk stratification models, patients with no relevant OSA syndrome tended to be at a lower risk for short-term mortality (p = 0.068). Acute PE might present more severely in OSA patients, possibly due to nocturnal hypoxemia or OSA-related hypercoagulability.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0929-5305
• Sprache: Englisch