ARYA Atheroscler. 2023 Jan;19(1):53-60. doi: 10.48305/arya.2022.11760.2392.
The occurrence of obstructive sleep apnea (OSA) and its health-related issues, especially cardiovascular diseases (CVD), are increasing in developing countries. With a 3-year follow-up study, the present study aimed to determine the incidence of cardiovascular events in patients with OSA in an Iranian population.
In this prospective cohort study, 415 adults (300 patients with OSA and 115 patients without OSA) with a history of snoring and/or witnessed apneas or other suspected sleep breathing disorders were consecutively enrolled and followed up for three successive years to evaluate the development of cardiovascular events including acute coronary syndrome, cerebrovascular accidents (including ischemic or hemorrhagic strokes or transient ischemic attacks), death due to cardiac causes and all-cause mortality.
415 patients were studied with a mean age of 56.2 ±15.7 years, 211 (50.8) of whom were male. Cardiovascular events developed in 15 participants (5%) of the OSA group, and 3 participants (2.6 %) of the OSA negative group. No significant differences were observed between the two groups in terms of the incidence of any of these events (P>0.05). Using multiple logistic regression model (with P<0.2 as the significance level), age, OSA, and history of CVD remained as significant predictors for the development of cardiac composite events (incidence of CVD, CVA, death due to cardiac causes, and all-cause mortality) with the odds ratios of (95% confidence interval) 1.03 (1.01, 1.06), 2.41 (1.02, 5.76), and 7.40 (2.91, 18.67), respectively.
The present study showed that OSA is associated with a more than twofold increased risk of cardiovascular events. Thus, obstructive sleep apnea should be considered an independent cardiovascular risk factor.
在发展中国家，阻塞性睡眠呼吸暂停（OSA）及其相关健康问题，尤其是心血管疾病（CVD）的发生率正在上升。本研究通过一项为期3年的随访研究，旨在确定伊朗人群中OSA患者心血管事件的发生率。
在这项前瞻性队列研究中，连续纳入了415名有打鼾和/或目击性呼吸暂停病史或其他疑似睡眠呼吸障碍的成年人（300名OSA患者和115名非OSA患者），并连续随访3年，以评估心血管事件的发生情况，包括急性冠状动脉综合征、脑血管意外（包括缺血性或出血性中风或短暂性脑缺血发作）、心源性死亡和全因死亡率。
共研究了415名患者，平均年龄为56.2±15.7岁，其中211名（50.8%）为男性。OSA组有15名参与者（5%）发生心血管事件，OSA阴性组有3名参与者（2.6%）发生心血管事件。两组在任何这些事件的发生率方面均未观察到显著差异（P>0.05）。使用多因素逻辑回归模型（以P<0.2为显著性水平），年龄、OSA和CVD病史仍然是心脏复合事件（CVD、CVA、心源性死亡和全因死亡率的发生率）发生的显著预测因素，其比值比（95%置信区间）分别为1.03（1.01,1.06）、2.41（1.02,5.76）和7.40（2.91,18.67）。
本研究表明，OSA与心血管事件风险增加两倍以上相关。因此，阻塞性睡眠呼吸暂停应被视为一个独立的心血管危险因素。
