Sleep Apnea Further Increases Cardiovascular Disease Risk in Individuals with Atrial Fibrillation

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摘要Objectives:Obstructive sleep apnea(OSA)and atrial fibrilla-tion(AF)are well-recognized risk factors for cardiovascular diseases and often coexist.We investigated whether the pres-ence of incident OSA in individuals with AF would further increase their risk of ischemic heart disease(IHD),heart failure(HF),and stroke or transient ischemic attack(TIA).Methods:Three separate propensity-score matched cohorts were generated for IHD(n=5,140),HF(n=6,372),and stroke/TIA(n=6,372)using an AF pool with 277,684 eligible participants(2000-2018)derived from the IQ VIA Medical Research Data(IMRD),a large UK-based primary care dataset.Competing risk Cox proportional hazard regression models were used to com-pare the risk of developing IHD,HF,and stroke/TIA between individuals with and without OSA during the follow-up period.Results:All baseline characteristics between individuals with and without OSA were well balanced after matching.The median follow-up period was 3(interquartile range:1 to 5)years.Compared to individuals without OSA,individuals with OSA have higher risks of IHD(adjusted hazard ratios,1.94;95％CI,1.42 to 2.65)and HF(1.31;95％CI,1.07 to 1.62)and an unchanged risk of stroke/TIA(1.06;95％CI,0.80 to 1.41).Conclusion:OSA in individuals with AF was associated with additional increased risk of IHD and HF,not with stroke/TIA.Further studies on the effect of active screening and manage-ment of OSA to prevent cardiovascular disease in individuals with AF are warranted.Individuals with AF may also benefit from including OSA as a part of clinical decision framework for the management of cardiovascular disease.

作者 Jingya Wang Christina Antza ^[2] Xian Shen ^[3] Tiffany Gooden Abd A Tahrani ^[5] Deirdre A Lane Anuradhaa Subramanian ^[7] Krishna Gokhale ^[8] Nicola J Adderley Rajendra Surenthirakumaran Paulo A Lotufo Yutao Guo Hao Wang G.Neil Thomas Gregory Y.H.Lip Krishnarajah Nirantharakumar On behalf of The NIHR Global AF Reach Group Ajini Arasalingam Abi Beane Isabela Bensenor Peter Brocklehurst Kar Keung Cheng Itamar de Souza Santos Mei Feng Alessandra Goulart Sheila Greenfield Mahesan Guruparan Gustavo Gusso Rashan Haniffa Lindsey Humphreys Kate Jolly Sue Jowett Balachandran Kumarendran Emma Lancashire Xuewen Li Gregory Y.H.Lip(co-PI) Yan-guang Li Trudie Lobban Paulo Lotufo Semira Manseki-Holland David Moore Rodrigo Olmos Carla Romagnolli Quintino Alena Shantsila Isabelle Szmigin Kumaran Subaschandren Meihui Tai G.Neil Thomas(co-PI) 学术成果认领

作者单位 Institute of Applied Health Research,University of Birmingham,Birmingham,UK ^[1] Institute of Metabolism and Systems Research,University of Birmingham,Birmingham,UK ^[2] University Hospitals Birmingham,Birmingham,UK ^[3] Institute of Metabolism and Systems Research,University of Birmingham,Birmingham,UK;Department of Diabetes and Endocrinology,University Hospitals Birmingham NHS Foundation Trust,Birmingham,UK;Centre for Endocrinology,Diabetes and Metabolism(CEDAM),Birmingham Health Partners,Birmingham,UK ^[4] Institute of Applied Health Research,University of Birmingham,Birmingham,UK;Liverpool Centre for Cardiovascular Science,University of Liverpool and Liverpool Heart & Chest Hospital,Liverpool,UK ^[5] Department of Community and Family Medicine,Faculty of Medicine,University of Jaffna,Jaffna,Sri Lanka ^[6] University Hospital,University of São Paulo,São Paulo,Brazil ^[7] Chinese PLA General Hospital,Beijing,China ^[8]

发布时间 2024-06-04