Faculty Opinions recommendation of Obstructive sleep apnea in patients with abdominal aortic aneurysms: highly prevalent and associated with aneurysm expansion.

BackgroundObstructive sleep apnea (OSA) is associated with an increased prevalence of aortic aneurysms, and it has also been suggested that severe OSA furthers aneurysm expansion in the abdomen. We evaluated whether OSA is a risk factor for the progression of ascending thoracic aortic aneurysms (TAA).MethodsPatients with TAA underwent yearly standardised echocardiographic measurements of the ascending aorta over 3 years, and two level-III sleep studies. The primary outcome was the expansion rate of TAA in relation to the apnea-hypopnea-index (AHI). Secondary outcomes included surveillance for aortic events (composite endpoints of rupture, dissection, elective surgery, and death).ResultsBetween July 2014 and March 2020, 230 patients (median age 70 years, 78% male) participated in the cohort. At baseline, 34.8% of patients had an AHI of ≥15 events·h−1. There was no association between TAA diameters and the AHI at baseline. After 3 years mean expansion rates were 0.55±1.25 mm at the aortic sinus and 0.60±1.12 mm at the ascending aorta. In the regression analysis, after controlling for baseline diameter and cardiovascular risk factors, there was strong evidence for a positive association of TAA expansion with AHI (aortic sinus estimate 0.025 mm [95%CI 0.009 to 0.040], p<0.001; ascending aorta estimate 0.026 mm [95%CI 0.011 to 0.041], p=0.001). Twenty participants (8%) experienced an aortic event, however, there was no association with OSA severity.ConclusionOSA may be a modest but independent risk factor for faster TAA expansion and thus potentially contributes to life-threatening complications in aortic disease.

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Prevalence Of Obstructive Sleep Apnoea (OSA) In 131 Patients With Abdominal Aortic Aneurysms (AAA), And It’s Relation To Rate Of Expansion

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3667 ◽

2010 ◽

Author(s):

Rebecca H. Mason ◽

Gion Ruegg ◽

Jeremy Perkins ◽

Maxine Hardinge ◽

Beatrice Amann-Vesti ◽

...

Keyword(s):

Obstructive Sleep Apnoea ◽

Abdominal Aortic Aneurysms ◽

Sleep Apnoea ◽

Aortic Aneurysms ◽

Abdominal Aortic ◽

Obstructive Sleep

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Relationship Between Abdominal Aortic Measurements And Severity Of Obstructive Sleep Apnea

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a3863 ◽

2012 ◽

Author(s):

William Goldhirsch ◽

Christopher Kim ◽

Nicholas Jackson ◽

Thorarinn Gislason ◽

Erna S. Arnardottir ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Abdominal Aortic ◽

Obstructive Sleep

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Abstract WP84: Obstructive Sleep Apnea May Worsen the Overall Outcome of Intracranial Aneurysms

Stroke ◽

10.1161/str.48.suppl_1.wp84 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Shyamal Bir ◽

Anil Nanda ◽

Hugo Cuellar ◽

Hai Sun ◽

Cesar Liendo ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Regression Analysis ◽

Sleep Apnea ◽

Intracranial Aneurysms ◽

Aortic Aneurysms ◽

Unfavorable Outcome ◽

Poor Outcome ◽

Obstructive Sleep ◽

Number Of Patients

Introduction: Obstructive sleep apnea (OSA) is associated with the progression of abdominal and thoracic aortic aneurysms. However, the role of OSA in the overall outcome of intracranial aneurysms (IAs) has not yet been established. We have investigated the role of OSA in the progression and outcome of intracranial aneurysms. Methods: Radiological and clinical data of 283 patients (from 2010 through 2015) were retrospectively reviewed. Significant differences between the OSA and non-OSA groups were determined by a chi-square test. Logistic regression analysis was performed to identify the predictors of unfavorable outcome. Results: Among the 283 patients with IAs, 45 (16%) patients were positively screened for OSA, a proportion that was significantly higher than the prevalence of OSA in the general population (4%), p=0.008. Number of patients with hypertension (p=0.018), BMI ≥ 30 (p<0.0001), hyperlipidemia (p=0.034), diabetes mellitus (DM, p=0.005), chronic heart disease (CHD, p=0.024), cerebrovascular accident (CVA, p=0.03) was significantly higher in the OSA group compared to the non-OSA group. Similarly, the number of wide neck aneurysms (p=0.00001) and poor Hunt and Hess grade 4-5 (p=0.01) was significantly higher in the OSA group compared to the non-OSA group. In addition, the number of ruptured aneurysms (p=0.03) and vasospasms (p=0.02) was significantly higher in the OSA group. The number of the patients with poor modified Rankin scale (mRS) scores (3-6) was significantly higher in the OSA group (p=0.03). Both in univariate (p=0.01) and multivariate (p=0.04) regression analysis, OSA was identified as an individual predictor of unfavorable outcome. In addition, hypertension, smoking, CHD and CVA were revealed as positive predictors of poor outcome of IAs. Conclusions: The complications of IAs such as rupture and vasospasms are influenced by presence of OSA. Overall outcome (mRS) of IAs is also affected by the concurrence of OSA. Therefore, coexistence of OSA in patients with IAs affects progression as well as outcome of IAs. Lastly, OSA serves as an individual risk factor for poor outcome in these patients.

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Prevalence of obstructive sleep apnea in patients with abdominal aortic aneurysm

10.1183/13993003.congress-2016.pa2352 ◽

2016 ◽

Author(s):

Jacques Hernigou ◽

Bassel Dakhil ◽

Laure Belmont ◽

Jean-Claude Couffinhal ◽

Patrick Bagan

Keyword(s):

Obstructive Sleep Apnea ◽

Abdominal Aortic Aneurysm ◽

Sleep Apnea ◽

Aortic Aneurysm ◽

Abdominal Aortic ◽

Obstructive Sleep

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Relationship of obstructive sleep apnea and cardiometabolic risk factors in elderly patients with abdominal aortic aneurysm

Sleep And Breathing ◽

10.1007/s11325-014-1053-2 ◽

2014 ◽

Vol 19 (2) ◽

pp. 593-598 ◽

Cited By ~ 4

Author(s):

Vittorio E. Bianchi ◽

William G. Herbert ◽

Jonathan Myers ◽

Paul M. Ribisl ◽

Larry E. Miller ◽

...

Keyword(s):

Risk Factors ◽

Obstructive Sleep Apnea ◽

Abdominal Aortic Aneurysm ◽

Sleep Apnea ◽

Aortic Aneurysm ◽

Elderly Patients ◽

Cardiometabolic Risk ◽

Abdominal Aortic ◽

Obstructive Sleep ◽

Relationship Of

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Coexistence of obstructive sleep apnea worsens the overall outcome of intracranial aneurysm: a pioneer study

Journal of Neurosurgery ◽

10.3171/2016.10.jns162316 ◽

2018 ◽

Vol 128 (3) ◽

pp. 735-746 ◽

Cited By ~ 3

Author(s):

Shyamal C. Bir ◽

Anil Nanda ◽

Hugo Cuellar ◽

Hai Sun ◽

Bharat Guthikonda ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Aortic Aneurysms ◽

Chi Square ◽

Chronic Heart Disease ◽

Obstructive Sleep ◽

Neurosurgical Patients ◽

Chi Square Test ◽

Prior Stroke

OBJECTIVEObstructive sleep apnea (OSA) is associated with the progression of abdominal and thoracic aortic aneurysms. However, the role of OSA in the overall outcome of intracranial aneurysms (IAs) has not yet been established. Authors of this report investigated the role of OSA in the overall outcome of IAs.METHODSRadiological and clinical data on patients (from 2010 through 2015) with confirmed IA were retrospectively reviewed. Significant differences between the OSA and non-OSA groups were determined using a chi-square test. Logistic regression analysis was performed to identify the predictors of an unfavorable IA outcome.RESULTSAmong the 283 patients with confirmed IAs, 45 patients (16%) were positively screened for OSA, a proportion that was significantly higher than the prevalence of OSA in nonaneurysmal neurosurgical patients (4%, p = 0.008). The percentage of patients with hypertension (p = 0.018), a body mass index ≥ 30 kg/m2 (p < 0.0001), hyperlipidemia (p = 0.034), diabetes mellitus (p = 0.005), chronic heart disease (CHD; p = 0.024), or prior stroke (p = 0.03) was significantly higher in the OSA group than in the non-OSA group. Similarly, the percentage of wide-necked aneurysms (p = 0.00001) and patients with a poor Hunt and Hess Grade IV–V (p = 0.01) was significantly higher in the OSA group than in the non-OSA group. In addition, the percentage of ruptured aneurysms (p = 0.03) and vasospasms (p = 0.03) was significantly higher in the OSA group. The percentage of patients with poor modified Rankin Scale (mRS) scores (3–6) was significantly higher in the OSA group (p = 0.03). A separate cohort of patients with ruptured IAs showed similar results. In both univariate (p = 0.01) and multivariate (p = 0.04) regression analyses, OSA was identified as an individual predictor of an unfavorable outcome. In addition, hypertension and prior stroke were revealed as predictors of a poor IA outcome.CONCLUSIONSComplications of IA such as rupture and vasospasm are often the consequence of uncontrolled OSA. Overall outcome (mRS) of IAs is also affected by the co-occurrence of OSA. Therefore, the coexistence of OSA with IA affects the outcome of IAs. Obstructive sleep apnea is a risk factor for a poor outcome in IA patients.

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