Obstructive Sleep Apnea Contributes to Risk of Recurrent PE
Obstructive sleep apnea is an independent risk factor for pulmonary embolism.
HealthDay News — For patients who stop oral anticoagulation (OAC) for a first episode of pulmonary embolism (PE), obstructive sleep apnea (OSA) is a risk factor for PE recurrence and restarting OAC for a new thromboembolic event, according to a study published in CHEST.
Alberto Alonso-Fernández, MD, PhD, from the University Hospital Son Espases in Palma de Mallorca, Spain, and colleagues examined the prognostic value of OSA after discontinuation of OAC in 120 patients with a first episode of PE. Patients were followed for 5 to 8 years for a primary end point of PE recurrence.
The researchers found that 19 patients had a PE recurrence during the follow-up period, and 16 of the patients had an apnea-hypopnea index (AHI) ≥10 h−1. Independent risk factors for recurrent PE included AHI ≥10 h−1, mean nocturnal oxygen saturation (nSaO2), time with SaO2 <90%, and D-dimer level (hazard ratios [HR]: 20.73, 0.39, 0.90, and 1.001, respectively). Twenty-four patients resumed OAC for any thromboembolic event; independent risk factors for the resumption of OAC included AHI ≥10 h−1, nSaO2, and Epworth Sleepiness Scale (HRs: 20.66, 0.54, and 0.73, respectively).
"After a first episode of PE, OSA is an independent risk factor for PE recurrence or restarting OAC for a new thromboembolic event," the authors wrote.
Alonso-Fernandez A, Suquia AG, de la Pena M, et al. OSA is a risk factor for recurrent VTE. Chest. 2016;150(6):1291-1301. doi:10.1016/j.chest.2016.07.011.