In patients with obstructive sleep apnoea (OSA), the number of minutes during a night of sleep where a patient’s oxygen saturation is 90% or lower (T90) was associated with the incidence of unprovoked venous thromboembolism (VTE). In contrast, the apnoea hypopnoea index (AHI), reflecting intermittent hypoxaemia in patients with OSA, was not a good predictor for VTE.
Several pathophysiological studies suggest that OSA might be a risk factor for VTE . However, a recent cohort study showed that the AHI may not be as good as a predictor for VTE as for sustained hypoxaemia . Prof. Wojciech Trzepizur (University of Angers, France) and his research team evaluated the relation between several measures of nocturnal hypoxaemia and unprovoked VTE in patients with OSA, to confirm the results of this recent study . Between 2007 and 2018, the disease profile of 7,355 patients with suspected OSA was composed via OSA severity markers, AHI, T90, the oxygen desaturation index (ODI), and the hypoxic burden (total area under the respiratory event-related desaturation curve).
Participants who experienced an unprovoked VTE (n=142) were generally older, had a higher BMI, and were more likely to have comorbidities. The unadjusted analysis showed a significant effect of T90 on the incidence of VTE (log T90; HR 1.10; P<0.0001). Likewise, a higher hypoxic burden was related to an increased occurrence of VTE. AHI and ODI did not demonstrate a link with the incidence of VTE. After adjustment for demographic factors and comorbidities, T90 was still associated with an increased risk of VTE events (log T90; HR 1.06; P=0.0216). Moreover, in participants who had an oxygen saturation below 90% for more than 6% of their total sleep time, the risk of unprovoked VTE was doubled (HR 1.98; P=0.0359). Hypoxic burden was no longer a significant predictor of VTE after controlling for confounding factors. Finally, the authors did not find an association between CPAP adherence and the risk of VTE.
“T90 was the only independent predictor of VTE in this study,” stressed Prof. Trzepizur. “These findings are consistent with the results that were reported by Genuardi et al. , confirming that T90 plays an important role in the occurrence of VTE events in patients with OSA.”
- Alonso-Fernandez A, et al. Sleep Med Rev. 2020;50:101223.
- Genuardi MV, et al. Chest. 2022;161(4):1073–1082.
- Trzepizur W, et al. Sleep apnea and incident unprovoked venous thromboembolism: Data from the French Pays de la Loire Sleep Cohort. Obstructive sleep apnea consequences and management, OA2288, ERS International Congress 2022, Barcelona, Spain, 4–6 September.
Copyright ©2022 Medicom Medical Publishers
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Table of Contents: ERS 2022
Letter from the Editor
ERS 2022 Highlights Podcast
COVID-19: What Is New?
Does vilobelimab reduce mortality in severe COVID-19?
Awake proning not positive in COVID-19
Favipiravir may help patients over 60 years with COVID-19 to recover
Brensocatib fails in severe COVID-19
Inhaled agent under investigation for COVID-19
Accurate voice-based COVID-19 diagnostic test in development
Novel scoring tool for post-COVID syndrome aids clinicians and researchers
COPD: Therapies and Innovations
Icenticaftor achieves results on top of triple inhalation therapy in COPD
STARR2: A new approach for treating COPD exacerbations
COPD medication not effective in symptomatic smokers with preserved spirometry
Do digital tools improve physical activity in COPD?
Hyperpolarised gas MRI ready for clinical use
All About Asthma
Tezepelumab in asthma: mucus plugging down, lung function up
Digital asthma intervention improves health and reduces costs
Digitally enhanced therapy lowers treatment burden and costs in severe asthma
Mepolizumab beneficial for patients with severe eosinophilic asthma
Progress in Paediatrics
Antibiotics cause increased risk of wheezing in severe RSV bronchiolitis
Inhaled corticosteroids useful in preterms with decreased lung function
Fish oil or vitamin D during pregnancy can prevent croup
Encouraging results of nintedanib in children with fibrosing ILD
Focus on Interventional Pulmonology
Head-to-head: lung volume reduction surgery vs endobronchial valves
Durable effect of endobronchial valves in severe emphysema
Cone beam CT-guided ENB improves detection of pulmonary nodules
Confirmatory mediastinoscopy not needed in resectable NSCLC
Sleep and Breathing Disorders
In the spotlight: Cancer trends in obstructive sleep apnoea
Impact of CPAP on cardiac endpoints in OSA
Sustained hypoxaemia predicts unprovoked VTE in OSA
CPAP therapy in the prevention of cardiovascular risk in patients with OSA
Other Remarkable Research
Excellent results for high-flow nasal cannula oxygen therapy in acute respiratory failure
Antifibrotic therapy may slow down FVC decline in RAILD
Intravenous N-acetylcysteine performs well in hospitalised patients
Men and women respond differently to diesel exhaust
New trends in cystic lung diseases
Secondhand vaping linked with respiratory symptoms in young adults