Cardiovascular Complications in Sleep Apnea May Be Rooted in Hypercoagulability

close up of blood clot in the blood stream
close up of blood clot in the blood stream
Patients with severe obstructive sleep apnea appear to have a higher risk for hypercoagulability, which can contribute to cardiovascular complications.

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.

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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