Sleep Apnea Increases the Risk of New Hospitalized Atrial Fibrillation: A Historical Cohort Study

Chest: The Journal of Circulation, Respiration and Related Systems

Paul Dorian^4,6¹  Andrea S. Gershon^3,4,5²  Clare Atzema^3,4,5³  Tetyana Kendzerska^1,2⁴  Gillian Hawker^3,4,7⁵  Iqwal Mangat^4,6⁶  Richard S. Leung^4,6⁷ 

[1] Department of Medicine, University of Toronto, Toronto, ON, Canada^4;ICES, Ottawa, ON, Canada^2;ICES, Toronto, ON, Canada^3;Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada^1;St. Michael’s Hospital, Toronto, ON, Canada^6;Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, ON, Canada^5;Women’s College Research Institute, Toronto, ON, Canada^7

关键词: atrial fibrillation/flutter;    prognosis;    sleep apnea syndromes;    AF;    atrial fibrillation;    AHI;    apnea-hypopnea index;    CHF;    congestive heart failure;    CIF;    cumulative incidence function;    HR;    hazard ratio;    MI;    myocardial infarction;    PAP;    positive airway pressure;    PSG;    polysomnography;    SaO2;    oxygen saturation;   

DOI  :  10.1016/j.chest.2018.08.1075

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Objectives This study examined the relationship between newly diagnosed OSA and incident hospitalized atrial fibrillation (AF) over the subsequent 10 years in a large arrhythmia-free cohort. Methods Adults referred between 1994 and 2010 to a large academic hospital with suspected OSA who were arrhythmia-free at the time of the first diagnostic sleep study were included. Clinical data were linked to provincial health administrative data to define outcome. Cox regressions were used to investigate the relationship between severity of OSA as measured by the apnea-hypopnea index (AHI) and degree of nocturnal hypoxemia, and incident hospitalized AF. Results In total, 8,256 subjects were included in this study. Their median age was 47 years, 62% were men; 28% had an AHI > 30 events per hour, and 6% spent > 30% of sleep time with oxygen saturation Conclusions In a large arrhythmia-free clinical cohort with suspected OSA, nocturnal hypoxemia was independently associated with a 77% increased hazard of incident hospitalized AF. These findings further support a relationship between OSA, nocturnal hypoxemia, and new-onset AF, and they may be used to enhance AF prevention in patients with OSA and severe nocturnal hypoxemia.

【 授权许可】

CC BY