Voulgaris Athanasios, Archontogeorgis Kostas, Papanas Nikolaos, Pilitsi Eleni, Nena Evangelia, Xanthoudaki Maria, Mikhailidis Dimitri P, Froudarakis Marios E, Steiropoulos Paschalis
MSc Programme in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Clin Respir J. 2019 Nov;13(11):708-715. doi: 10.1111/crj.13078. Epub 2019 Sep 8.
Accumulating evidence suggests that cardiovascular disease (CVD) is highly prevalent among patients with concurrent obstructive sleep apnoea syndrome (OSAS) and chronic obstructive pulmonary disease, otherwise known as overlap syndrome (OS).
The aim of this study was to investigate the 10-year risk for CVD in OS patients compared with OSAS patients and controls.
Consecutive patients, referred for symptoms suggestive of OSAS, were evaluated with polysomnography and pulmonary function testing. Cardiovascular risk was assessed using the Framingham risk score (FRS) and systematic coronary risk evaluation (SCORE).
Overall, 244 participants (184 males) without CVD and diabetes were divided into 3 groups: controls (n = 63), OSAS (n = 139) and OS (n = 42). Both FRS and SCORE were found to be elevated in the OS group compared with the OSAS and control groups (P < .001 for all). In multivariate analysis, age (β = .461, P < .001), forced expiratory volume in first second (β = -.285, P = .036) and oxygen desaturation index (ODI) (β = .234, P = .007) were major determinants for the SCORE, whereas age (β = .308, P < .001) and apnoea-hypopnoea index (β = .252, P = .010) for the FRS.
In our study, an increased risk for CVD was observed in a group of patients with OS at the time of their initial evaluation. Further studies are needed in the field of OS in order to investigate, prevent and manage early CVD in this population.
越来越多的证据表明，在同时患有阻塞性睡眠呼吸暂停综合征（OSAS）和慢性阻塞性肺疾病（即重叠综合征，OS）的患者中，心血管疾病（CVD）极为常见。
本研究旨在调查重叠综合征患者与阻塞性睡眠呼吸暂停综合征患者及对照组相比，发生心血管疾病的10年风险。
对因疑似阻塞性睡眠呼吸暂停综合征症状而转诊的连续患者进行多导睡眠图和肺功能测试评估。使用弗雷明汉风险评分（FRS）和系统性冠状动脉风险评估（SCORE）评估心血管风险。
总体而言，244名无心血管疾病和糖尿病的参与者（184名男性）被分为3组：对照组（n = 63）、阻塞性睡眠呼吸暂停综合征组（n = 139）和重叠综合征组（n = 42）。与阻塞性睡眠呼吸暂停综合征组和对照组相比，重叠综合征组的弗雷明汉风险评分和系统性冠状动脉风险评估均升高（所有P值均<0.001）。多变量分析中，年龄（β = 0.461，P < 0.001）、第1秒用力呼气量（β = -0.285，P = 0.036）和氧饱和度下降指数（ODI）（β = 0.234，P = 0.007）是系统性冠状动脉风险评估的主要决定因素，而年龄（β = 0.308，P < 0.001）和呼吸暂停低通气指数（β = 0.252，P = 0.010）是弗雷明汉风险评分的主要决定因素。
在我们的研究中，一组重叠综合征患者在初次评估时即观察到心血管疾病风险增加。重叠综合征领域需要进一步研究，以调查、预防和管理该人群的早期心血管疾病。
