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Original Research: Sleep Disorders |

OSA and Coronary Plaque CharacteristicsOSA and Coronary Plaque Characteristics

Adeline Tan, MBBS; William Hau, PhD; Hee-Hwa Ho, MBBS; Haleh Ghaem Maralani, MSc; Germaine Loo; See-Meng Khoo, MBBS; Bee-Choo Tai, PhD; A. Mark Richards, MD, PhD; Paul Ong, MD; Chi-Hang Lee, MD
Author and Funding Information

From the Division of Respiratory Medicine (Drs Tan and Khoo), University Medical Cluster, National University Health System; Department of Medicine (Drs Hau, Richards, and Lee and Ms Loo), Yong Loo Lin School of Medicine, National University of Singapore; Department of Cardiology (Drs Ho and Ong), Tan Tock Seng Hospital; Saw Swee Hock School of Public Health (Ms Ghaem Maralani and Dr Tai), National University of Singapore, National University Health System; and Department of Cardiology (Drs Richards and Lee), National University Heart Centre, Singapore.

Correspondence to: Chi-Hang Lee, MD, Department of Cardiology, National University Heart Centre, Singapore, 1E Kent Ridge Rd, NUHS Tower Block Level 9, Singapore 119228; e-mail: mdclchr@nus.edu.sg


Dr Tan is currently at Alexandra Hospital (Jurong Health Services) (Singapore).

Funding/Support: This study was funded by the Academic Research Fund [Grant R172-000-239-112] of the Ministry of Education, Singapore.

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


Chest. 2014;145(2):322-330. doi:10.1378/chest.13-1163
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Background:  Virtual histology intravascular ultrasound (VH-IVUS) is an intravascular imaging technique that enables the characterization of coronary plaques. We sought to determine the association between OSA and coronary plaque characteristics in patients presenting with coronary artery disease.

Methods:  We prospectively recruited patients with angiographically proven coronary artery disease for a VH-IVUS examination and home-based sleep study. The total atheroma volume of the entire target coronary artery and the incidence of thin cap fibroatheroma of patients with no to mild and moderate to severe OSA were compared.

Results:  One hundred eighteen patients were recruited from two university-affiliated centers. Among the 93 patients who completed the study, 32 (34.4%) had newly diagnosed moderate to severe OSA (apnea-hypopnea index > 15). Compared with patients with no to mild OSA, those with moderate to severe OSA had a larger total atheroma volume (461.3 ± 250.4 mm3 vs 299.2 ± 135.6 mm3, P < .001), and the association remained after adjustment for age, BMI, hypertension, diabetes mellitus, smoking, and hyperlipidemia (relative mean difference, 1.73; 95% CI, 1.38-2.15). In contrast, there were no significant differences between the patients with moderate to severe OSA and no to mild OSA regarding the prevalence of thin cap fibroatheroma in the culprit lesion (53.1% vs 54.2%, P = .919).

Conclusions:  In patients presenting with coronary artery disease, moderate to severe OSA was independently associated with a larger total atheroma volume in the target coronary artery. Further studies on the effects of CPAP on total atheroma volume are warranted.

Trial registry:  ClinicalTrials.gov; No.: NCT01306526; URL: www.clinicaltrials.gov

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