Objective: Investigating potential predictors of aortic dissection
development in high-risk hypertensive patients with obstructive sleep
apnea syndrome (OSAS). Methods: Hypertensive patients with aortic
dissection, admitted to hospital between January 2010 and July 2020, was
diagnosed with OSAS by overnight sleep study with polysomnography (PSG).
Results: Male was liable to aortic dissection compared to female in both
groups（84.7% and 86% respectively）.There were actually significant
differences with regard to neutrophil to lymphocyte ratio (NLR),
platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) /
platelet count (PLT) ratio and D-dimer that we concerned about and were
of great value in aortic dissection as previously reported. As
multivariable regression analysis revealed, NLR (odds rate [OR],
2.258, 95% confidence interval [CI], 1.464-3.482,
P<0.05), MPV/PLT (OR, 2.743, 95%CI, 1.713-4.392,
P<0.05) and apnea and hypopnea index (AHI) (OR, 1.746,95% CI,
1.225-1.320, P<0.05) were all independent risk factors for
aortic dissection. receiver operating characteristic curves analysis of
NLR, MPV/PLT, AHI and combination of indicators for aortic dissection
revealed combination of NLR, MPV/PLT ratio and AHI is of outstanding
predictive value with sensitivity of 0.904 and specificity of 0.847. At
the thresholds of 4.41 for NLR and 5.14 for MPV/PLT and 35.95 for AHI,
87.5% of all studied patients were expected to be correctly diagnosed
with regard to aortic dissection. Conclusion: Inflammation, platelet
alteration is crucial for initiation and progression of aortic
dissection. Combined detection of NLR, MPV/PLT ratio and AHI could
assist sleep physicians to identify silent or potential aortic
dissection in patient comorbidity OSAS and hypertension.
Autonomic regulation of blood circulation in hypertensive patients with obstructive sleep apnea syndrome
