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Original Research |

Obstructive Sleep Apnea Is Associated With Increased High-Sensitivity Cardiac Troponin T LevelsObstructive Sleep Apnea and Cardiac Troponin T

Anna Randby, MD; Silje K. Namtvedt, MD; Gunnar Einvik, MD; Harald Hrubos-Strøm, MD; Tor-Arne Hagve, MD, PhD; Virend K. Somers, MD, PhD, FCCP; Torbjørn Omland, MD, PhD, MPH; Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction
Author and Funding Information

From the Division of Medicine (Drs Randby, Namtvedt, Einvik, and Omland), the Department of Otorhinopharyngology (Dr Hrubos-Strøm), and the Division of Diagnostics and Technology (Dr Hagve), Akershus University Hospital, Lørenskog; and the K. G. Jebsen Cardiac Research Centre, Center for Heart Failure Research and Institute of Clinical Medicine (Drs Randby, Namtvedt, Einvik, and Omland), and the Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences (Dr Hrubos-Strøm), University of Oslo, Oslo, Norway; and the Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation (Dr Somers), Rochester, MN.

Correspondence to: Professor Torbjørn Omland, MD, PhD, MPH, Division of Medicine, Akershus University Hospital, NO-1478 Lørenskog, Norway; e-mail: torbjorn.omland@medisin.uio.no


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Funding/Support: This work was supported by the South-Eastern Norway Regional Health Authority [Grants 2004219, 2007048] and the University of Oslo, Oslo, Norway.


Chest. 2012;142(3):639-646. doi:10.1378/chest.11-1779
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Background:  Obstructive sleep apnea (OSA) is associated with increased cardiovascular risk. Stress imposed on the myocardium by repeated severe hypoxemia and/or BP surges during sleep may result in subclinical myocardial injury. A high-sensitivity cardiac troponin T (hs-cTnT) assay has been developed. We hypothesized that the severity of OSA, as assessed by the apnea-hypopnea index (AHI), is associated with circulating levels of hs-cTnT in the general population.

Methods:  Five hundred five subjects drawn from the general population (age range, 30-65 years; 45% women) underwent in-hospital polysomnography and had morning blood samples drawn. Oversampling of subjects at high risk of OSA was performed.

Results:  Overall, hs-cTnT was detectable (≥ 3 ng/L) in 216 subjects (42.8%). After categorizing subjects according to AHI cutoffs that correspond to no, mild to moderate, and severe OSA, the proportion of subjects with detectable hs-cTnT levels increased with increasing severity of OSA (P for trend < .001). Multivariate logistic regression with detectable hs-cTnT as the dependent variable was used to further assess the association between OSA and troponin T. After adjustment for significant univariate predictors of detectable hs-cTnT, the association between AHI and hs-cTnT was no longer statistically significant.

Conclusions:  The prevalence of detectable hs-cTnT increases in proportion to OSA severity, but this association is likely to be caused by a clustering of cardiovascular risk factors among subjects with OSA.

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