oam1998@outlook.com / Background: Obstructive sleep apnea (OSA) is associated
with increased mortality, for which impaired functional capacity
(IFC) has been established as a surrogate. We sought to assess
whether IFC is associated with increased mortality in patients
with OSA and whether IFC is predictive of increased mortality
after accounting for coronary artery disease.
Methods: Patients with OSA who underwent both polysomnography
testing and exercise stress echocardiogram were selected. Records
were reviewed retrospectively for demographics, comorbidities,
stress echocardiographic parameters, and polysomnography data.
Univariable and multivariable logistic regression analysis was used to
evaluate the association between IFC and overall mortality. We then
evaluated the variables associated with IFC in the overall population
and in the subgroup with normal Duke treadmill score (DTS).
Results: In our cohort, 404 (26%) patients had IFC. The best
predictors of IFC were female sex, history of smoking, ejection
fraction less than 55, increased body mass index, presence of
comorbidities, abnormal exercise echocardiogram, abnormal
heart rate recovery, and abnormal DTS. Compared with those
without IFC, patients with IFC were 5.1 times more likely to die
(odds ratio [OR], 5.1; 95% confidence interval [CI], 2.5–10.5; P ,
0.0001) by univariate analysis and 2.7 times more likely to die (OR,
2.7; 95% CI, 1.2–6.1; P = 0.02) by multivariate analysis, when
accounting for heart rate recovery, DTS, and sleep apnea severity.
Among those without coronary artery disease, patients with IFC
were at significantly increased risk of mortality (OR, 4.3; 95%
CI, 1.35–13.79; P = 0.0088) compared with those with preserved
functional capacity.
Conclusions: In our OSA population, IFC was a strong predictor
of increased mortality. Among those with normal DTS, IFC
identified a cohort at increased risk of mortality.
| Identifer | oai:union.ndltd.org:PERUUPC/oai:repositorioacademico.upc.edu.pe:10757/337271 |
| Date | 16 December 2014 |
| Creators | Nisar, Shiraz A., Muppidi, Raghunandan, Duggal, Sumit, Hernández, Adrian V., Kalahasti, Vidyasagar, Jaber, Wael, Minai, Omar A. |
| Publisher | The American Thoracic Society |
| Source Sets | Universidad Peruana de Ciencias Aplicadas (UPC) |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/article |
| Source | Universidad Peruana de Ciencias Aplicadas (UPC), Repositorio Académico - UPC |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | http://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201309-315OC#.VJCdb9IrfTo |
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