Département de Médecine Vasculaire, Interne et Pneumologie, EA3878, Groupe d'Etude de la Thrombose de Bretagne Occidentale, Centre hospitalo-universitaire de Brest, Université de Bretagne Occidentale, Brest, France.
Centre d'Investigation Clinique INSERM 1412, Brest, France.
Thromb Haemost. 2021 Jun;121(6):808-815. doi: 10.1055/s-0040-1721506. Epub 2020 Dec 30.
In patients with pulmonary embolism (PE), there is a lack of comprehensive data on the prevalence and prognostic significance of pre-existing obstructive sleep apnea (OSA).
In this study of patients with PE from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry, we assessed the prevalence of OSA, and the association between pre-existing OSA and the outcomes of all-cause mortality, PE-related mortality, recurrences, and major bleeding over 30 days after initiation of PE treatment. Additionally, we also examined rates of outcomes within 90 days and 1 year following the diagnosis of PE.
Of 4,153 patients diagnosed with PE, 241 (5.8%; 95% confidence interval [CI]: 5.1-6.6%) had pre-existing OSA. Overall, 166 (4.0%; 95% CI: 3.4-4.6%) died during the first 30 days of follow-up. In multivariable analysis, the OSA syndrome was not a significant predictor of death from any cause (odds ratio [OR]: 1.5; 95% CI: 0.8-2.9; = 0.19). However, patients with pre-existing OSA had an increased PE-specific mortality (adjusted OR: 3.0; 95% CI: 1.3-6.8; = 0.01) compared with those without OSA. OSA was not significantly associated with 30-day recurrent venous thromboembolism (adjusted OR: 0.6; 95% CI: 0.1-4.7; = 0.65) or major bleeds (adjusted OR: 1.0; 95% CI: 0.4-2.2; = 1.0). Findings were similar at 90-day and 1-year follow-ups.
In patients presenting with PE, pre-existing OSA is relatively infrequent. Patients with OSA were at increased risk of PE-related mortality when compared with those without OSA.
在患有肺栓塞 (PE) 的患者中，普遍缺乏关于先前存在的阻塞性睡眠呼吸暂停 (OSA) 的患病率和预后意义的综合数据。
在这项来自 Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) 登记处的 PE 患者研究中，我们评估了 OSA 的患病率，以及先前存在的 OSA 与全因死亡率、PE 相关死亡率、复发和 30 天后开始治疗 PE 后的大出血等结局之间的关联。此外，我们还检查了 PE 诊断后 90 天和 1 年内结局的发生率。
在 4153 名诊断为 PE 的患者中，有 241 名（5.8%；95%置信区间 [CI]：5.1-6.6%）存在先前存在的 OSA。总体而言，有 166 名（4.0%；95%CI：3.4-4.6%）在随访的头 30 天内死亡。在多变量分析中，OSA 综合征不是任何原因死亡的显著预测因素（比值比 [OR]：1.5；95%CI：0.8-2.9； = 0.19）。然而，与没有 OSA 的患者相比，先前存在 OSA 的患者的 PE 特异性死亡率增加（调整后的 OR：3.0；95%CI：1.3-6.8； = 0.01）。OSA 与 30 天内复发性静脉血栓栓塞（调整后的 OR：0.6；95%CI：0.1-4.7； = 0.65）或大出血（调整后的 OR：1.0；95%CI：0.4-2.2； = 1.0）没有显著关联。在 90 天和 1 年随访时也发现了类似的结果。
在患有 PE 的患者中，先前存在的 OSA 相对少见。与没有 OSA 的患者相比，患有 OSA 的患者的 PE 相关死亡率增加。
