Sleep Disorders |

Uric Acid as a Potential Mediator of Cardiovascular Morbidity in Obstructive Sleep Apnea Syndrome FREE TO VIEW

Asiye Kanbay, MD; Handan Inonu, MD; Yalcin Solak, MD; Abdulsamet Erden, MD; Emine Uslu, MD; Sevgi Yuksel, MD; Mehmet Ozturk, MD; Kim McFann, MD; Richard Johnson, MD; Mehmet Kanbay, MD
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Istanbul Medeniyet University School of Medicine, Istanbul, Turkey

Chest. 2014;145(3_MeetingAbstracts):607A. doi:10.1378/chest.1835967
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SESSION TYPE: Slide Presentations

PRESENTED ON: Monday, March 24, 2014 at 10:45 AM - 11:45 AM

PURPOSE: Obstructive sleep apnea (OSA) is now considered as an independent risk factor for cardiovascular (CV) disease. Although uric acid is increasingly being implicated in CV morbidity and mortality, no study attempted to determine independent role of uric acid in CV morbidity of OSA patients. We aimed to assess the role of serum uric acid as a potential mechanism of CV morbidity in a nonselected cohort of OSA patients.

METHODS: This was a cohort study in which patients who had undergone a formal sleep study for diagnosis of OSA were recruited. Included patients were grouped according to apne-hypopnea index (AHI) as mild, moderate and severe OSA. Patients with AHI<5 served as control group. Patients were interrogated as to cardiovascular morbid conditions which included prior history and an established diagnosis of coronary artery disease, cerebrovascular accident, congestive heart failure due to coronary artery disease and arrhythmias.

RESULTS: 436 OSA patients included (72 controls, 97 with mild, 75 with moderate, and 192 with severe OSA). The severe group also had higher serum uric acid level compared with the control and other OSA groups. Linear regression showed that the Ln Uric Acid was positively associated with Ln AHI score. In unadjusted logistic regression, severe OSA was associated with higher odds of a cardiovascular event, OR= 2.81 (1.307-6.041), p = 0.0081 while the other categories of sleep apnea were not. However, severe OSA was no longer significant after adjusting for age, gender, diabetes mellitus status, hypertension status, BMI, and smoking, OR = 1.882 (0.826-4.287), p = 0.1322. Uric Acid was significantly higher in those who had a cardiovascular event even in the mild, moderate and severe OSA groups.

CONCLUSIONS: Hyperuricemia is strongly associated with cardiovascular disease in OSA patients. This strong relationship persists even after controlling for well-known traditional risk factors for cardiovascular disease.

CLINICAL IMPLICATIONS: Hyperuricemia is an independent risk factor for development of cardiovascular disease in sleep apnea.

DISCLOSURE: Richard Johnson: Grant monies (from sources other than industry): NIH The following authors have nothing to disclose: Asiye Kanbay, Handan Inonu, Yalcin Solak, Abdulsamet Erden, Emine Uslu, Sevgi Yuksel, Mehmet Ozturk, Kim McFann, Mehmet Kanbay

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