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.
The opportunities of non-invasive ventilation in the treatment of drug-resistant hypertensive patients with obstructive sleep apnea syndrome
