Impaired Functional Capacity Predicts Mortality in Patients with Obstructive Sleep Apnea

5.00
Hdl Handle:
http://hdl.handle.net/10757/337271
Title:
Impaired Functional Capacity Predicts Mortality in Patients with Obstructive Sleep Apnea
Authors:
Nisar, Shiraz A.; Muppidi, Raghunandan; Duggal, Sumit; Hernández, Adrian V. ( 0000-0002-9999-4003 ) ; Kalahasti, Vidyasagar; Jaber, Wael; Minai, Omar A.
Publisher:
The American Thoracic Society
Journal:
Annals of the American Thoracic Society
Issue Date:
16-Dec-2014
URI:
http://hdl.handle.net/10757/337271
DOI:
10.1513/AnnalsATS.201309-315OC
Additional Links:
http://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201309-315OC#.VJCdb9IrfTo
Abstract:
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.
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/openAccess
Language:
eng
Description:
oam1998@outlook.com
Keywords:
Sleep apnea; Coronary artery disease; Mortality; Polysomnography; Impaired functional capacity

Full metadata record

DC FieldValue Language
dc.contributor.authorNisar, Shiraz A.es_PE
dc.contributor.authorMuppidi, Raghunandanes_PE
dc.contributor.authorDuggal, Sumites_PE
dc.contributor.authorHernández, Adrian V.es_PE
dc.contributor.authorKalahasti, Vidyasagares_PE
dc.contributor.authorJaber, Waeles_PE
dc.contributor.authorMinai, Omar A.es_PE
dc.date.accessioned2014-12-16T21:01:51Z-
dc.date.available2014-12-16T21:01:51Z-
dc.date.issued2014-12-16-
dc.identifier.doi10.1513/AnnalsATS.201309-315OCes_PE
dc.identifier.urihttp://hdl.handle.net/10757/337271es_PE
dc.descriptionoam1998@outlook.comes_PE
dc.description.abstractBackground: 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.eng
dc.formatapplication/pdfes_PE
dc.language.isoenges_PE
dc.publisherThe American Thoracic Societyes_PE
dc.relation.urlhttp://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201309-315OC#.VJCdb9IrfToes_PE
dc.rightsinfo:eu-repo/semantics/openAccesses_PE
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Académico - UPCes_PE
dc.subjectSleep apneaes_PE
dc.subjectCoronary artery diseasees_PE
dc.subjectMortalityes_PE
dc.subjectPolysomnographyes_PE
dc.subjectImpaired functional capacityes_PE
dc.titleImpaired Functional Capacity Predicts Mortality in Patients with Obstructive Sleep Apneaes_PE
dc.typeinfo:eu-repo/semantics/articlees_PE
dc.identifier.journalAnnals of the American Thoracic Societyes_PE
dc.description.peer-reviewRevisión por paress
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