Obstructive sleep apnea severity and its association with coronary artery disease requiring revascularization

Introduction:

Obstructive sleep apnea (OSA) is a chronic disorder leading to intermittent hypoxia, oxidative stress and vascular inflammation. These mechanisms are recognized contributors to atherosclerotic cardiovascular disease (CVD). The objective of this study was to evaluate the correlation between the severity of obstructive sleep apnea (OSA) and the presence of coronary artery disease (CAD) that necessitates revascularization procedures.

Materials and Methods:

A restrospective analysis was conducted on 70 patients treated between 2022 and 2024. Demographic data, comorbidities, sleep polygraphy results were reviewed. Patients were divided into two groups: mild/no OSA (apnea–hypopnea index [AHI] < 15 events/h) and moderate to severe OSA (AHI ≥15 events/h).

Results:

Group I (n=35) included patients with no to mild OSA, while group II (n=35) comprised patients with moderate to severe OSA. The prevalence of ischemic heart disease requiring revascularization was more frequent in patients with moderate to severe OSA compared with those with mild/no OSA (52.9% vs. 47.1%). A subgroup analysis demonstrated that patients with severe OSA had a significantly higher prevalence of coronary artery disease requiring revascularization (41.2%) compared to those without OSA (14.7%), with mild OSA (32.3%), or moderate OSA (11.8%), with these differences being statistically significant (p = 0.01). No statistically significant association was found between the severity of sleep apnea and either the number of affected vessels or the involvement of a specific coronary artery by atherosclerotic lesions.

Conclusions:

The prevalence of CAD requiring revascularization was higher in patients with moderate to severe OSA. These findings emphasize the importance of systematic screening and management of OSA, particularly in patients with advanced CAD undergoing coronary interventions.