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OSA & Subclinical Myocardial Injury

OSA & Subclinical Myocardial Injury

About 2% to 6% of Americans have obstructive sleep apnea (OSA), a condition that is largely underdiagnosed but has been associated with multiple cardiovascular diseases (CVDs), including coronary heart disease (CHD) and heart failure (HF). “Although the relationship between OSA and CVD has been well defined,” says Amil M. Shah, MD, MPH, “it has been challenging for clinicians to establish a causal relationship because of the association of OSA with other risk factors.” In clinical research, elevated levels of high sensitivity troponin T (hs-TnT), a marker of myocardial injury, have been predictive of both CHD and HF in the general population. Previous studies have been conflicting as to whether there is a link between OSA severity and troponin levels, particularly after accounting for comorbidities. “The relationship between OSA severity and hs-TnT levels has not been well described in the literature,” says Dr. Shah. “More severe OSA may be associated with subclinical myocardial injury.” Understanding the relationship between OSA and CVD pathway biomarkers may help explain the association between the diseases.   New Data Dr. Shah and colleagues had a study published in the American Journal of Respiratory and Critical Care Medicine to determine if more severe OSA, measured by the respiratory disturbance index, is associated with subclinical myocardial injury and increased myocardial wall stress. Subclinical myocardial injury was indicated by increased hs-TnT levels, while increased myocardial wall stress was indicated by elevated N-terminal pro B-type natriuretic peptide (NT-proBNP) levels. The analysis included 1,645 community-based, middle-aged and older patients who were part of the Atherosclerosis Risk in Communities and the Sleep Health studies. Participants were free of CHD and HF...
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