Cardiovascular Complications in Sleep Apnea May Be Rooted in Hypercoagulability

Patients with moderate to severe obstructive sleep apnea (OSA) may have a higher risk for hypercoagulability that can potentially contribute to cardiovascular complications according to a study published by JAMA Otolaryngology-Head & Neck Surgery. 

Researchers identified 105 patients with mild, moderate, or severe OSA and compared them with 41 control patients. The following coagulation tests were performed in all participants after a 12-hour fasting period: platelet (PLT) count, bleeding time (BT), prothrombin time (PT) in seconds and as international normalized ratio (INR), and activated partial thromboplastin time (aPTT).

The results demonstrated a longer PT duration in the control group compared with the moderate OSA (mean difference [MD], 0.52; 95%CI, 0.27-1.01) and severe OSA group (MD, 0.59; 95%CI, 0.14-1.03). In addition, the PT INR ratio in the control group was greater than in patients with moderate (median difference, 0.04; 95%CI, 0.01- 0.07) and severe OSA (median difference, 0.05; 95%CI, 0.02-0.08). No significant difference was found between the control group and the mild OSA group (MD, 0.34; 95%CI, –0.14 to 0.82) for PT seconds. No association was found between the severity of OSA and laboratory tests aPTT, BT, or PLT.

There was a significant correlation found between the apnea-hypopnea index and PT seconds (Spearman r coefficient, –0.30; 95%CI, –0.44 to –0.14) and PT INR (Spearman r coefficient, –0.30; 95%CI, –0.44 to –0.14).

The investigators concluded that patients with moderate to severe OSA have increased blood coagulation markers compared with patients without OSA, which may contribute to cardiovascular complication occurrences.

Reference

Hong S-N, Yun H-C, Yoo JH, Lee SH.  Association between hypercoagulability and severe obstructive sleep apnea [published online August 17, 2017].  JAMA Otolaryngol Head Neck Surg.  doi:10.1001/jamaoto.2017.1367