scholarly journals Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Manyun Tang ◽  
Yidan Wang ◽  
Mengjie Wang ◽  
Rui Tong ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p < 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

scholarly journals Prevalence of Cardiovascular Events and Their Risk Factors in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Overlap Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Manyun Tang ◽  
Yunxiang Long ◽  
Shihong Liu ◽  
Xin Yue ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Partial Pressure ◽  
Cardiovascular Events ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Prevalence Rates ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Rationale: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been identified as independent risk factors for cardiovascular diseases. However, the impact of COPD and OSA overlap syndrome (OS) on cardiovascular outcomes remains to be elucidated.Objective: To determine the prevalence of cardiovascular events and their risk factors in OS patients.Methods: Seventy-four patients who had OS between January 2015 and July 2020 were retrospectively enrolled, and 222 COPD-only patients and 222 OSA-only patients were pair-matched for age and sex from the same period and served as the OS-free control group. The prevalence rates of coronary heart disease (CHD), arrhythmia, heart failure, and pulmonary arterial hypertension (PAH) were compared among the three groups, and multivariable logistic regression models were used to screen the risk factors for specific cardiovascular events.Results: OS patients had higher prevalence rates of heart failure (10.8 vs. 0.5 and 1.4%, respectively) and PAH (31.1 vs. 4.5 and 17.1%, respectively) than those with OSA alone or COPD alone (all P < 0.01). The CHD prevalence was also significantly higher in the OS group than in the COPD-alone group (25.7 vs. 11.7%, P < 0.01). There was no significant difference in the prevalence of arrhythmia among the three groups (20.3, 22.5, and 13.1%, respectively, P > 0.05). In OS patients, risk factors for CHD included hypertension, diabetes, body mass index, lactate dehydrogenase level, and tidal volume; risk factors for heart failure included diabetes, partial pressure of oxygen, partial pressure of carbon dioxide, maximum ventilatory volume, and neutrophilic granulocyte percentage; and risk factors for PAH included minimum nocturnal oxygen saturation, partial pressure of carbon dioxide, and brain natriuretic peptide and lactate dehydrogenase levels.Conclusions: OS patients have a higher prevalence of cardiovascular events, which is associated with hypoxemia, hypercapnia, and impaired lung function in these patients.

scholarly journals Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China: a cross-sectional study

2021 ◽  
Author(s):  
Pan Zhang ◽  
Bi Chen ◽  
Heqing Lou ◽  
Yanan Zhu ◽  
Peipei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Overlap Syndrome ◽  
Neck Circumference ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Independent Risk Factors

Abstract ‘Overlap syndrome’ refers to obstructive sleep apnea (OSA) combined with chronic obstructive pulmonary disease (COPD), and has poorer outcomes than either condition alone. We aimed to evaluate the prevalence and possible predictors of overlap syndrome and its association with clinical outcomes in patients with COPD. We conducted a cross-sectional study in 842 patients with COPD. We assessed the modified Medical Research Council dyspnea scale (mMRC), Epworth sleepiness scale (ESS), COPD assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), Charlson Comorbidity Index (CCI), and STOP-Bang questionnaire (SBQ) and performed spirometry and full overnight polysomnography in all patients. An apnea–hypopnea index (AHI) ≥ 5 events per hour was considered to indicate OSA. Participants were divided into a COPDOSA group with AHI ≥ 15 events per hour and a COPD group with AHI < 15 events per hour. Risk factors for OSA in COPD patients were identified by univariate and multivariate logistic regression analyses. A total of 556 patients (66%) had an AHI ≥ 5 events per hour. There were no significant differences in age, sex ratio, mMRC score, smoking index, number of acute exacerbations and hospitalizations in the last year, and prevalence of cor pulmonale between the two groups (all p > 0.05). Body mass index (BMI), neck circumference, CAT score, CCI, ESS, HADS, and SBQ scores, forced expiratory volume (FEV)1, FEV1%, FEV1/forced vital capacity ratio, and prevalence of hypertension, coronary heart disease, and diabetes were all significantly higher and the prevalence of severe COPD was significantly lower in the COPDOSA group compared with the COPD group (p < 0.05). BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in COPD patients (p < 0.05). SBQ could be used for OSA screening in patients with COPD. Patients with severe COPD (FEV1% <50%) had a lower risk of OSA compared with patients with mild or moderate COPD (β=−0.459, odds ratio = 0.632, 95% confidence interval 0.401–0.997, p = 0.048). Conclusions Patients with overlap syndrome had a poorer quality of life, more daytime sleepiness, and a higher prevalence of hypertension and diabetes than patients with COPD alone. BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in patients with COPD. The risk of OSA was lower in patients with severe, compared with mild or moderate COPD.

scholarly journals Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Pan Zhang ◽  
Bi Chen ◽  
Heqing Lou ◽  
Yanan Zhu ◽  
Peipei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Overlap Syndrome ◽  
Neck Circumference ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Independent Risk Factors ◽  
Severe Copd

Abstract Background “Overlap syndrome” refers to obstructive sleep apnea (OSA) combined with chronic obstructive pulmonary disease (COPD), and has poorer outcomes than either condition alone. We aimed to evaluate the prevalence and possible predictors of overlap syndrome and its association with clinical outcomes in patients with COPD. Methods We assessed the modified Medical Research Council dyspnea scale (mMRC), Epworth sleepiness scale (ESS), COPD assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), Charlson Comorbidity Index (CCI), and STOP-Bang questionnaire (SBQ) and performed spirometry and full overnight polysomnography in all patients. An apnea–hypopnea index (AHI) ≥ 5 events per hour was considered to indicate OSA. Risk factors for OSA in COPD patients were identified by univariate and multivariate logistic regression analyses. Results A total of 556 patients (66%) had an AHI ≥ 5 events per hour. There were no significant differences in age, sex ratio, mMRC score, smoking index, number of acute exacerbations and hospitalizations in the last year, and prevalence of cor pulmonale between the two groups (all p > 0.05). Body mass index (BMI), neck circumference, CAT score, CCI, ESS, HADS, and SBQ scores, forced expiratory volume (FEV)1, FEV1% pred, FEV1/forced vital capacity ratio, and prevalence of hypertension, coronary heart disease, and diabetes were all significantly higher and the prevalence of severe COPD was significantly lower in the COPD-OSA group compared with the COPD group (p < 0.05). BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in COPD patients (p < 0.05). SBQ could be used for OSA screening in patients with COPD. Patients with severe COPD had a lower risk of OSA compared with patients with mild or moderate COPD (β =  − 0.459, odds ratio = 0.632, 95% confidence interval 0.401–0.997, p = 0.048). Conclusion Patients with overlap syndrome had a poorer quality of life, more daytime sleepiness, and a higher prevalence of hypertension and diabetes than patients with COPD alone. BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in patients with COPD. The risk of OSA was lower in patients with severe, compared with mild or moderate COPD.

scholarly journals Mortality Prediction in Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea

2021 ◽  
Author(s):  
Eunhye Bae ◽  
Nakwon Kwak ◽  
Sun Mi Choi ◽  
Jinwoo Lee ◽  
Young Sik Park ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulmonary Disease ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinical Model ◽  
Obstructive Sleep ◽  
All Cause Mortality

Abstract Background: Overlap syndrome of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is associated with increased mortality. We aimed to assess all-cause mortality in patients with COPD, OSA, and the overlap syndrome and evaluate which polysomnographic indices—apnea-hypopnea index (AHI) or hypoxemic load measurements—better predict mortality within 10 years.Methods: Adults who underwent polysomnography, spirometry, and bronchodilator response tests between 2000 and 2018 were included and divided into four groups according to the presence of COPD and moderate-to-severe OSA (AHI ³15/h). We estimated mortality using Cox model adjusted for demographic/anthropometric covariates and comorbidities; this was called the clinical model. To evaluate prognostic performance, we compared the concordance index (C-index) between the clinical model and extended models, which incorporated one of the polysomnographic indices—AHI, sleep time spent with SpO2 < 90% (TS90), and mean and lowest SpO2.Results: Among 355 participants, patients with overlap syndrome of COPD and moderate-to-severe OSA had the highest risk of death (adjusted hazard ratio, 3.19; 95% confidence interval, 1.02 to 9.96). The C-indices of the extended models with TS90 (%) and mean SpO2 were significantly higher than that of the clinical model (0.765 vs. 0.737 and 0.756 vs. 0.737, respectively; all P <0.05); however, the C-index of the extended model with AHI was not (0.739 vs. 0.737; P=0.15).Conclusions: All-cause mortality was highest in patients with the overlap syndrome. The measurements of the hypoxemic load, not AHI, better predicted mortality in patients with COPD, OSA, and the overlap syndrome.

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