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Unrecognised obstructive sleep apnoea is common in severe peripheral arterial disease.
MedLine Citation:
PMID:  22700841     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Patients needing surgery for peripheral arterial disease (PAD) represent a severe form of atherosclerosis with an overall five-year mortality of 30 % after revascularisation. The aetiology for poor postoperative clinical outcome in these high-risk patients is not fully established. Obstructive sleep apnoea (OSA) is associated with atherosclerosis and is an independent risk factor for fatal and non-fatal cardiac events. Here we determine the prevalence of undiagnosed OSA in a homogenous group of PAD patients undergoing sub-inguinal surgical revascularisation.Eighty-two consecutive patients (mean age 67±9, 52 males) with sinus rhythm and without congestive heart failure or previously diagnosed OSA were enrolled for preoperative polysomnography and echocardiography.OSA was present in 70 (85%) patients (95% confidence interval 75-93%), of whom 24 (34%) had severe OSA. OSA was mostly asymptomatic, and age and gender adjusted multivariate regression analysis showed no relation to obesity, metabolic syndrome or any manifestation of atherosclerosis, other than PAD. Left ventricular ejection fraction (P=0.002) and high density lipoprotein/total cholesterol ratio (P=0.03) were the only independent predictors for the severity of OSA.Thus, prevalence of OSA is unexpectedly high in patients with PAD and is not related to classical risk factors of sleep apnoea.
Authors:
Karri T Utriainen; Juhani K Airaksinen; Olli Polo; Olli T Raitakari; Mikko J Pietilä; Harry Scheinin; Hans Y Helenius; Kari A Leino; Erkki S Kentala; Jouko R Jalonen; Harri Hakovirta; Tiina M Salo; Timo T Laitio
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-14
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  -     ISSN:  1399-3003     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Turku University Hospital, P.O.B. 52, 20521 Turku, Finland.
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