文献类型：期刊文献

英文题名：Association of Metabolic Syndrome With Long-Term Cardiovascular Risks and All-Cause Mortality in Elderly Patients With Obstructive Sleep Apnea

作者：Liu, Lin[1,2];Su, Xiaofeng[3];Zhao, Zhe[1,2];Han, Jiming[3];Li, Jianhua[4,5];Xu, Weihao;He, Zijun[3,4];Gao, Yinghui[6];Chen, Kaibing[7];Zhao, Libo;Gao, Yan[8];Wang, Huanhuan[3];Guo, JingJing[9];Lin, Junling[10];Li, Tianzhi[11,12];Fang, Xiangqun[1,2]

第一作者：Liu, Lin

通信作者：Fang, XQ[1];Fang, XQ[2];Lin, JL[3];Li, TZ[4];Li, TZ[5]

机构：[1]Second Med Ctr, Dept Pulm & Crit Care Med, Beijing, Peoples R China;[2]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[3]Yanan Univ, Med Coll, Yanan, Peoples R China;[4]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Dept Cardiol, Beijing, Peoples R China;[5]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[6]Peking Univ, Int Hosp, PKU UPenn Sleep Ctr, Beijing, Peoples R China;[7]Gansu Univ Chinese Med, Affiliated Hosp, Sleep Ctr, Lanzhou, Peoples R China;[8]960th Hosp PLA, Dept Gen Practice, Jinan, Peoples R China;[9]Peking Univ, Peoples Hosp, Sleep Med Ctr, Dept Pulm & Crit Care Med, Beijing, Peoples R China;[10]Capital Med Univ, Beijing Chaoyang Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China;[11]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Beijing, Peoples R China;[12]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China

第一机构：Second Med Ctr, Dept Pulm & Crit Care Med, Beijing, Peoples R China

通信机构：[1]corresponding author), Second Med Ctr, Dept Pulm & Crit Care Med, Beijing, Peoples R China;[2]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[3]corresponding author), Capital Med Univ, Beijing Chaoyang Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China;[4]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Beijing, Peoples R China;[5]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China.

年份：2022

卷号：8

外文期刊名：FRONTIERS IN CARDIOVASCULAR MEDICINE

收录：;WOS:【SCI-EXPANDED(收录号:WOS:000761005100001)】；

语种：英文

外文关键词：obstructive sleep apnea; metabolic syndrome; elderly; major adverse cardiovascular events; mortality; cardiovascular disease

摘要：BackgroundEvidence suggests that an increased risk of major adverse cardiac events (MACE) and all-cause mortality is associated with obstructive sleep apnea (OSA), particularly in the elderly. Metabolic syndrome (MetS) increases cardiovascular risk in the general population; however, less is known about its influence in patients with OSA. We aimed to assess whether MetS affected the risk of MACE and all-cause mortality in elderly patients with OSA. MethodsFrom January 2015 to October 2017, 1,157 patients with OSA, aged >= 60 years, no myocardial infarction (MI), and hospitalization for unstable angina or heart failure were enrolled at baseline and were followed up prospectively. OSA is defined as an apnea-hypopnea index of >= 5 events per hour, as recorded by polysomnography. Patients were classified on the basis of the presence of MetS, according to the definition of the National Cholesterol Education Program (NCEP). Incidence rates were expressed as cumulative incidence. Cox proportional hazards analysis was used to estimate the risk of all events. The primary outcomes were MACE, which included cardiovascular death, MI, and hospitalization for unstable angina or heart failure. Secondary outcomes were all-cause mortality, components of MACE, and a composite of all events. ResultsMetS was present in 703 out of 1,157 (60.8%) elderly patients with OSA. During the median follow-up of 42 months, 119 (10.3%) patients experienced MACE. MetS conferred a cumulative incidence of MACE in elderly patients with OSA (log-rank, P < 0.001). In addition, there was a trend for MACE incidence risk to gradually increase in individuals with >= 3 MetS components (P = 0.045). Multivariate analysis showed that MetS was associated with an incidence risk for MACE [adjusted hazard ratio (aHR), 1.86; 95% confidence interval (CI), 1.17-2.96; P = 0.009], a composite of all events (aHR, 1.54; 95% CI, 1.03-2.32; P = 0.036), and hospitalization for unstable angina (aHR, 2.01; 95% CI, 1.04-3.90; P = 0.039). No significant differences in the risk of all-cause mortality and other components of MACE between patients with and without MetS (P > 0.05). Subgroup analysis demonstrated that males (aHR, 2.23; 95% CI, 1.28-3.91, P = 0.05), individuals aged <70 years (aHR, 2.36; 95% CI, 1.27-4.39, P = 0.006), overweight and obese individuals (aHR, 2.32; 95% CI, 1.34-4.01, P = 0.003), and those with moderate-severe OSA (aHR, 1.81;95% CI: 1.05-3.12, P = 0.032) and concomitant MetS were at a higher risk for MACE. ConclusionMetS is common in elderly patients with OSA in the absence of MI, hospitalization for unstable angina or heart failure. Further, it confers an independent, increased risk of MACE, a composite of all events, and hospitalization for unstable angina. Overweight and obese males, aged <70 years with moderate-severe OSA combined with MetS presented a significantly higher MACE risk.