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Sleep apnea is associated with subclinical myocardial injury in the community. The ARIC-SHHS study.

TitleSleep apnea is associated with subclinical myocardial injury in the community. The ARIC-SHHS study.
Publication TypeJournal Article
Year of Publication2013
AuthorsRoca GQuerejeta, Redline S, Punjabi N, Claggett B, Ballantyne CM, Solomon SD
Secondary AuthorsShah AM
JournalAm J Respir Crit Care Med
Volume188
Issue12
Pagination1460-5
Date Published2013 Dec 15
ISSN1535-4970
KeywordsAged, Asymptomatic Diseases, Biomarkers, Cardiomyopathies, Cross-Sectional Studies, Female, Humans, Linear Models, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Polysomnography, Proportional Hazards Models, Risk Factors, Severity of Illness Index, Sleep Apnea, Obstructive, Troponin T
Abstract

RATIONALE: Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity and mortality, although the underlying mechanisms are not well understood.

OBJECTIVES: We aimed to determine whether more severe OSA, measured by the Respiratory Disturbance Index (RDI), is associated with subclinical myocardial injury and increased myocardial wall stress.

METHODS: A total of 1,645 participants (62.5 ± 5.5 yr and 54% women) free of coronary heart disease and heart failure and participating in both the Atherosclerosis Risk in the Communities and the Sleep Heart Health Studies underwent overnight polysomnography and measurement of high-sensitivity troponin T (hs-TnT) and N-terminal pro B-type natriuretic peptide (NT-proBNP).

MEASUREMENTS AND MAIN RESULTS: OSA severity was defined using conventional clinical categories: none (RDI ≤ 5), mild (RDI 5-15), moderate (RDI 15-30), and severe (RDI > 30). Hs-TnT, but not NT-proBNP, was associated with OSA after adjusting for 17 potential confounders (P = 0.02). Over a median of 12.4 (interquartile range, 11.6-13.1) years follow-up, hs-TnT was related to risk of death or incident heart failure in all OSA categories (P ≤ 0.05 in each category).

CONCLUSIONS: In middle-aged to older individuals, OSA severity is independently associated with higher levels of hs-TnT, suggesting that subclinical myocardial injury may play a role in the association between OSA and risk of heart failure. OSA was not associated with NT-proBNP levels after adjusting for multiple possible confounders.

DOI10.1164/rccm.201309-1572OC
Alternate JournalAm J Respir Crit Care Med
PubMed ID24156237
PubMed Central IDPMC3917380
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
K08 HL116792 / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
U01HL53934 / HL / NHLBI NIH HHS / United States
NHLBI-HC-11-08 / HC / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
U01 HL053934 / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
1K08HL116792-01A1 / HL / NHLBI NIH HHS / United States