Document Detail

New index for analysis of polysomnography, 'integrated area of desaturation', is associated with high cardiovascular risk in patients with mild to moderate obstructive sleep apnea.
MedLine Citation:
PMID:  19218786     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although obstructive sleep apnea (OSA) severity is evaluated by the apnea-hypopnea index (AHI), the value of AHI in evaluating cardiovascular risks, especially in mild to moderate OSA, is unclear. OBJECTIVES: The purpose of this study is to evaluate the validity of a new index, the integrated area of desaturation (IAD), to detect the incidence of cardiovascular events (CVEs) in such patients. METHODS: We enrolled 230 consecutive patients with mild to moderate OSA and 354 with severe OSA diagnosed by polysomnography, of whom 53 and 112, respectively, had CVEs. The IAD was calculated by dividing the area of desaturation by total sleep time in polysomnography. C-reactive protein (CRP) was also measured for all patients. RESULTS: In the mild to moderate OSA patients, the mean IAD of the CVEs group was significantly higher than that of the non-CVE group (94.4 +/- 82.7 vs. 62.3 +/- 50.8, p = 0.001), whereas mean AHI and 3% oxygen desaturation index were similar in both groups. Multivariate analysis demonstrated that the IAD was an independent variable for CVEs (OR 1.006, 95% confidence interval 1.001-1.012, p = 0.031). Moreover, the IAD level of the high CRP group was significantly higher than that of the low CRP group (92.9 +/- 84.8 vs. 63.9 +/- 54.5, p = 0.009). There was no significant difference in AHI, IAD or other polysomnographic parameters in the severe OSA patients. CONCLUSIONS: IAD might be superior to AHI alone in the evaluation of the history of CVEs in mild to moderate OSA patients, and it deserves attention as a possible predictor of future CVEs.
Kihiro Asano; Yoshifumi Takata; Yasuhiro Usui; Kazuki Shiina; Yuki Hashimura; Kota Kato; Hirokazu Saruhara; Akira Yamashina
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Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2009-02-16
Journal Detail:
Title:  Respiration; international review of thoracic diseases     Volume:  78     ISSN:  1423-0356     ISO Abbreviation:  Respiration     Publication Date:  2009  
Date Detail:
Created Date:  2009-09-29     Completed Date:  2010-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0137356     Medline TA:  Respiration     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  278-84     Citation Subset:  IM    
Copyright Information:
(c) 2009 S. Karger AG, Basel.
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
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MeSH Terms
C-Reactive Protein / metabolism*
Cardiovascular Diseases / blood,  diagnosis*,  epidemiology,  etiology
Japan / epidemiology
Middle Aged
Multivariate Analysis
Risk Factors
Sleep Apnea, Obstructive / blood,  complications*,  epidemiology
Reg. No./Substance:
9007-41-4/C-Reactive Protein

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