Title: Cardiovascular Profile of Patients With Obstructive Sleep Apnea
Abstract: Sleep-disordered breathing is a common condition affecting up to 9% of middle aged women and 24% of middle-aged men (1). Obstructive sleep apnea (OSA) is increasingly being recognized as an important public health problem in the last two to three decades. Accumulating data suggests that obstructive sleep apnea is being considered as an independent risk factor for cardio metabolic diseases and leading to increased morbidity and mortality. In an effort to quantify the risk of OSA patients for cardiovascular disease, we decided to study cardiovascular profile in patients with established OSA. Ours was a Prospective Observational study. Our study included 87 subjects, who were diagnosed to have obstructive sleep apnea by overnight Polysomnography. Our study shows that there is strong association between severity of Obstructive sleep apnea & coronary artery disease. Objectives of the study• To study association between severity of Obstructive sleep apnea and coronary artery disease. • To study association between severity of Obstructive sleep apnea and various components of metabolic syndrome Material and MethodsTotal of 87 subjects,who fulfilled our inclusion and exclusion criteria and were diagnosed to have obstructive sleep apnea by polysomnography were further studied. • Both males and females were included. • Age group= 21 years to 65 years old • Body mass index > 23 • Waistcircumference (measured in a horizontal plane midway between the inferior margin of the ribs and superior border of the iliac crest): for males > 90cm and for females > 80cm. • Patients having symptoms of obstructive sleep apnea and high snore score. Patients fulfilling above criteria were subjected for overnight polysomnography & those who were diagnosed to have obstructive sleep apnea (i.e. AHI >5, were included in the study), were included in the study. Exclusion Criteria• Sleep disorders other than OSA. • Habitual drinker (more than three times per week), history of smoking. • Underlying lung disease-obstructive, restrictive. • Past history of Ischemic heart disease. • Congestive cardiac failure, or evidence of LV dysfunction. • Patients on steroid treatment, hormone replacement therapy, or with chronic use of drugs such as non-steroidal anti-inflammatory drugs, oral anticoagulants and lipid-lowering drugs. • History of Cerebrovascular disease,Cardiovascular disease, Chronic renal failure, Hypothyroidism. • Pregnant females. Data collection technique and tools• A detailed history was taken. • All patients were examined thoroughly. • Subjects who were willing for further studies and gave written consent, undewent overnight polysomnography. Depending on polysomnography results were divided into mild (AHI 5-15),moderate(AHI 15-30) and severe (AHI >30) [2]. CT Coronary/Conventional Coronary AngiographyPatients who had positive Stress test were subjected for conventional/ CT coronary angiography. Patients who had low probability (i.e. young females, lesser risk factors etc) were subjected for CT coronary angiography while elderly who had risk factors and likely hood of high Ca score were subjected for conventional coronary angiography. 50% luminal stenosis = significant 8.5 Data analysisWe have used chi-square test, Fishers exact test (when cell count is 30) [2].. Total 87 subjects were enrolled in the study. Their age ranged from 21 to 65years.These subjects were divided