Data from population-based cohorts suggest that symptom subtypes, and OSA-specific hypoxic burden (HB) could help to better identify patients with OSA at high cardiovascular (CV) risk.
We aimed to evaluate whether those new markers are associated with the risk of major adverse CV events (MACE) in clinical setting.
Data from the Pays de la Loire cohort were linked to health administrative data to identify the occurrence of MACE (a composite outcome including all-cause mortality, acute myocardial infarction, stroke, and unplanned coronary revascularization) in patients with newly diagnosed OSA and no overt CV disease. Latent class analysis was used to identify subtypes based on 8 clinically relevant variables. HB was defined as the total area under the respiratory event-related desaturation curve. Cox proportional hazards models were used to evaluate the association of symptom subtypes and HB with MACE.
Four symptom subtypes were identified (minimally symptomatic [22.0%], disturbed sleep [17.5%], excessively sleepy [49.8%], and moderately sleepy [10.6%]). After a median [inter-quartile range] follow-up of 78 months [52-109], 592 (11.05%) of 5,358 patients experienced MACE. In a fully adjusted model, HB and overall nocturnal hypoxemia assessed by sleep time with oxygen saturation <90% were the only predictors of MACE (HR 1.21; 95%CI [1.07-1.38] and 1.34 [1.16-1.55] respectively). The association appeared stronger towards younger patients and women.
In clinical setting, patients with OSA who demonstrate elevated OSA specific HB are at higher risk of CV event and all-cause mortality. Symptom subtypes were not associated with MACE after adjustment for confounders.