El Jamal Nadim, Brooks Thomas G, Skarke Carsten, FitzGerald Garret A
Institute for Translational Medicine and Therapeutics (ITMAT), University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Bldg 421, Philadelphia, PA, USA.
Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Am J Prev Cardiol. 2025 Mar 9;22:100958. doi: 10.1016/j.ajpc.2025.100958. eCollection 2025 Jun.
Circadian disruption and sleep disorders have been shown to increase the risk for many cardiovascular diseases. Their association specifically with valvular heart disease, however, is inconclusive. In this study we test the association between sleep disorders and the future incidence of aortic stenosis using two large electronic health record (EHR) databases datasets (the TriNetX network and the All Us study). We also explore biochemical data for potential mechanistic insights into that association.
We fitted Cox proportional hazards models to quantify the risk of future incidence of AS in patients with sleep disorders. We also explored clinical laboratory test datasets for biochemical signals that might explain the association, running mediation analyses.
In our fully adjusted Cox models, we find that having any sleep disorder increases the risk for the future incidence of AS (HR: 1.15 95 % CI: 1.13-1.18). Changes in lipid profile mediate a proportion of that association.
Sleep disorders are associated with an increased risk of AS incidence. That association is independent of classical cardiovascular risk factors even though dyslipidemia plays a large role in mediating this risk.
昼夜节律紊乱和睡眠障碍已被证明会增加多种心血管疾病的风险。然而，它们与心脏瓣膜病的具体关联尚无定论。在本研究中，我们使用两个大型电子健康记录（EHR）数据库数据集（TriNetX网络和全民研究）来检验睡眠障碍与未来主动脉瓣狭窄发病率之间的关联。我们还探索生化数据，以深入了解该关联背后的潜在机制。
我们拟合Cox比例风险模型，以量化睡眠障碍患者未来发生主动脉瓣狭窄的风险。我们还探索临床实验室测试数据集，寻找可能解释这种关联的生化信号，并进行中介分析。
在我们经过充分调整的Cox模型中，我们发现患有任何睡眠障碍都会增加未来发生主动脉瓣狭窄的风险（风险比：1.15，95%置信区间：1.13 - 1.18）。血脂谱的变化在一定程度上介导了这种关联。
睡眠障碍与主动脉瓣狭窄发病率增加有关。这种关联独立于经典心血管危险因素，尽管血脂异常在介导这种风险中起很大作用。
