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Abstract: Slide Presentations |

INDEPENDENT ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA AND VULNERABLE PLAQUE DEMONSTRATED BY NON-INVASIVE CORONARY CT ANGIOGRAPHY FREE TO VIEW

Sunil Sharma, MD*; Joseph U. Schoepf, MD; Andrew M. Armstrong; Adrian T. Parker; Joseph A. Abro
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East Carolina University, Greenville, NC


Chest


Chest. 2009;136(4_MeetingAbstracts):67S-f-68S. doi:10.1378/chest.136.4_MeetingAbstracts.67S-f
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Abstract

PURPOSE:  Obstructive Sleep Apnea (OSA) has been linked with coronary artery disease (CAD). Coronary CT angiography (cCTA) is a non-invasive means to evaluate atherosclerotic plaque burden and “Vulnerable plaques” (calcified / mixed plaques) which are implicated in development of acute coronary syndrome. The study investigated the association between OSA and vulnerable plaques.

METHODS:  A total of 95 patients who had undergone 64 slice dual energy CT scan (cCTA) for atypical chest pain and/or prior equivocal physiological testing were included in the study. Patients were screened for presence of OSA by polysomnograpy (45/95) or Berlin questionnaire (50/95). 49 patients were found to have OSA (AHI>15/hr) with mean AHI of 50 (+/− 32) and 45 patients without OSA with mean AHI 5.5 (+/− 4.5). Two experienced radiologists analyzed the cCTA data and were blinded to the results of the polysomnograms. Results of vulnerable plaques (non-calcified and mixed plaques) were analyzed between patients with OSA versus non OSA.

RESULTS:  Vulnerable plaques were present in 55 % of patients with OSA as compared to 28 % of non OSA patients (p=0.014). Number of vessel involvement for vulnerable plaques was also higher in OSA patients (20% one vessel, 22% two vessels, 10% three vessels and 4 % four vessels versus 11%, 9%, 4%, 4% in non OSA, P=.05). Patients with OSA also had significantly higher prevalence of stenotic CAD (88%) versus non OSA (59%) (p=0.0013) and higher calcium score (272±422 with OSA versus 241±415 without OSA, p=0.5).There was no statistically significant (p>0.05) difference in baseline demographics (age, gender, body mass index, cardiovascular risk factors) between patients with and without OSA.

CONCLUSION:  Presence of OSA is independently associated with presence and extent of vulnerable plaques and severity of stenotic coronary artery disease.

CLINICAL IMPLICATIONS:  If above findings are confirmed in a larger prospective trial, identification of OSA would be helpful in risk stratification of patients with atherosclerosis and acute coronary artery syndrome.

DISCLOSURE:  Sunil Sharma, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

2:15 PM - 3:15 PM


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