Severe obstructive sleep apnea is associated with significant coronary artery plaque burden independent of traditional cardiovascular risk factors

Lin Mo, Vivek Gupta, Rohan Modi, Kiran Munnur, James D. Cameron, Sujith Seneviratne, Bradley A. Edwards, Shane A. Landry, Simon A. Joosten, Garun S. Hamilton, Dennis T.L. Wong

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Obstructive Sleep Apnea (OSA) is strongly associated with adverse cardiovascular events. In these patients, increased oxidative stress has been associated with accelerated coronary atherosclerosis. However, it is unclear if OSA is associated with significant coronary artery plaque burden. Our aim is to determine whether OSA and/or markers of hypoxemia are associated with coronary plaque burden (CPB). Patients who had coronary computed tomography angiography (CCTA) and a polysomnogram within 1 year of each other between 2011 and 2016 were analyzed. Apnea–Hypopnea Index (AHI) and hypoxemic burden (ODI3%, ODI4%, nadir SpO2, average spO2 and time of spO2 < 88%) were obtained from the polysomnogram. Total CPB was assessed using the prognostically validated CT-Leaman score (CT-LeSc). Significant CPB was defined as CT-LeSc ≥ 8.3. There were 119 patients with mean (± SD) age of 59 ± 12 years. Using logistical regression analysis; AHI, ODI4% and ODI3% were the only parameters associated with significant CPB. Severe OSA (AHI ≥ 30 events/h) was associated with significant CPB with adjusted OR of 3.21 (p = 0.010) independent of traditional cardiovascular risk factors. Mechanisms associated with apnea and hypopnea events (as measured by AHI, ODI3% and ODI4%), but not the severity of arterial desaturation (nadir SpO2, burden of SpO2 < 88%) were associated with significant CPB.

Original languageEnglish
Pages (from-to)347-355
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
Issue number2
Publication statusPublished - Feb 2020


  • Computed tomography coronary angiogram
  • Coronary artery disease
  • Hypoxia
  • Obstructive sleep apnea

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