文献类型：期刊文献

英文题名：Association of Homocysteine and Risks of Long-Term Cardiovascular Events and All-Cause Death among Older Patients with Obstructive Sleep Apnea: A Prospective Study

作者：Liu, L.[1,2];Su, X.[1,2,3];Zhao, L.[2,4,5];Li, J.[2,5];Xu, W.[2,5];Yang, L.[3];Yang, Y.[3];Gao, Y.[6];Chen, K.[7];Gaol, Y.[8];Guo, J. J.[9];Wang, H.[1,2];Ling, J.[10];Hang, J.[3];Fan, L.[2,5];Fang, X.[1,2]

第一作者：Liu, L.

通信作者：Fang, X[1];Fan, L[2];Fang, X[2];Fan, L[3]

机构：[1]Chinese Peoples Liberat Army Gen Hosp, Dept Pulm & Crit Care Med, Med Ctr 2, Beijing 100853, Peoples R China;[2]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing 100853, Peoples R China;[3]Yanan Univ, Med Coll, Yanan, Shanxi, Peoples R China;[4]Chinese Peoples Liberat Army Gen Hosp, Grad Sch Med Sch, Beijing, Peoples R China;[5]Chinese Peoples Liberat Army Gen Hosp, Cardiol Dept, Med Ctr 2, Beijing 100853, Peoples R China;[6]Peking Univ Int Hosp, PKU UPenn Sleep Ctr, Beijing, Peoples R China;[7]Gansu Univ Chinese Med, Sleep Ctr, Affiliated Hosp, Lanzhou, Gansu, Peoples R China;[8]960th Hosp PLA, Dept Gen Practice, Jinan, Shandong, Peoples R China;[9]Peking Univ Peoples Hosp, Sleep Med Ctr, Dept Pulm & Crit Care Med, Beijing, Peoples R China;[10]Capital Med Univ, Dept Pulm & Crit Care Med, Beijing Chaoyang Hosp, Beijing, Peoples R China

第一机构：Chinese Peoples Liberat Army Gen Hosp, Dept Pulm & Crit Care Med, Med Ctr 2, Beijing 100853, Peoples R China

通信机构：[1]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Dept Pulm & Crit Care Med, Med Ctr 2, Beijing 100853, Peoples R China;[2]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing 100853, Peoples R China;[3]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Cardiol Dept, Med Ctr 2, Beijing 100853, Peoples R China.

年份：2022

卷号：26

期号：9

起止页码：879

外文期刊名：JOURNAL OF NUTRITION HEALTH & AGING

收录：;Scopus(收录号：2-s2.0-85138098061);WOS:【SCI-EXPANDED(收录号:WOS:000853287700002)】；

语种：英文

外文关键词：Total homocysteine; sleep apnea; obstructive; older; major adverse cardiovascular events; all-cause death

摘要：Objectives This study aimed to assess whether raised baseline plasma tHcy concentrations increased the risks of major adverse cardiovascular events (MACE) and all-cause death outcomes in older patients with obstructive sleep apnea (OSA). Design A multicenter, prospective, observational study. Setting Beijing, Shandong Province, Gansu Province of China. Participants A total of 1, 290 OSA patients aged 60 to 96 years from sleep centers of six hospitals in China consecutively recruited between January 2015 and October 2017. Measurements Cox proportional models assessed the association between tHcy and the risk of new-onset all events among Chinese older OSA patients. Results The final analysis (60.1% male; median age, 66 years) used data from 1, 100 subjects during a median follow-up of 42 months, a total of 105 (9.5%) patients developed MACE and 42 (3.8%) patients died. Multivariable Cox regression analysis showed higher adjusted hazard ratios (aHRs) of MACE, myocardial infarction (MI), hospitalization for unstable angina, and composite of all events with tHcy levels in the 4th quartile (HR=5.93, 95% CI: 2.79-12.59; HR=4.72, 95% CI:1.36-4.61; HR=4.26, 95% CI:1.62-5.71; HR=4.17, 95% CI:2.23-7.81) and the 3rd quartile (HR=3.79, 95% CI:1.76-8.20; HR=3.65, 95% CI:1.04-2.98; HR=2.75, 95% CI:1.08-3.76; HR=2.51, 95% CI:1.31-4.83) compared to reference tHcy levels in quartile 1, respectively, while the aHRs (95% CIs) of all-cause death showed significantly higher only in the highest tHcy level quartile than in the lowest quartile (HR=3.20, 95% CI=1.16-8.84, P=0.025) with no significant differences in risks of cardiovascular death and hospitalisation for heart failure among groups (P>0.05). Conclusions tHcy, a marker of prognosis for older OSA patients, was significantly associated with the increased risk of MACE and all-cause death in this population independent of BMI, smoking status, and other potential risk factors, but not all clinical components events of MACE. New therapeutic approaches for older patients with OSA should mitigate tHcy-associated risks of MACE, and even all-cause death.