Association between hypercoagulability and severe obstructive sleep apnea

Seung No Hong, Hee Chul Yun, Joon Hyuk Yoo, Seung Hoon Lee

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

IMPORTANCE: Obstructive sleep apnea (OSA) is related to the increased risk of cardiovascular disease. Although the pathogenesis of this association remains unclear, an alteration in coagulability is suspected as a link. OBJECTIVE: To investigate the association between the severity of OSA and blood coagulability. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study conducted at a tertiary care university hospital evaluated 146 patients with OSA from January 1, 2009, to July 31, 2015. The participants were divided into 4 groups according to the severity of OSA: control, mild, moderate, and severe. MAIN OUTCOMES AND MEASURES: Association between the severity of OSA and coagulation test results, including platelet count, bleeding time, prothrombin time (PT) in seconds and as international normalized ratio (INR), and activated partial thromboplastin time. RESULTS: Of the 146 patients, 135 (92.5%) were men; mean (SD) age was 34.8 (11.1) years. The control group included 41 (28.1%) patients; mild OSA, 32 (21.9%); moderate OSA, 30 (20.5%); and severe OSA, 43 (29.5%). Significant correlations were found between the apnea-hypopnea index and the 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). There were significant differences between the OSA severity groups for PT seconds for the control group (mean, 11.26 [0.78] seconds) vs the moderate OSA group (10.74 [0.62] seconds; mean difference [MD], 0.52; 95% CI, 0.27 to 1.01) and the severe OSA group (10.67 [0.77] seconds; MD, 0.59; 95% CI, 0.14 to 1.03). Significant differences were also noted in PT INR between the control group (1.00 [0.07]) vs the moderate OSA group (0.95 [0.05]; MD, 0.04; 95% CI, 0.01 to 0.07) and the severe OSA group (0.94 [0.07]; MD, 0.05; 95% CI, 0.02 to 0.08). However, there was no significant difference between the control and mild OSA groups in PT seconds. CONCLUSIONS AND RELEVANCE: These results suggest that patients with moderate to severe OSA have elevated blood coagulability markers compared with healthy individuals, which may contribute to the occurrence of cardiovascular complications.

Original languageEnglish
Pages (from-to)996-1002
Number of pages7
JournalJAMA Otolaryngology - Head and Neck Surgery
Volume143
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1

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Thrombophilia
Obstructive Sleep Apnea
Prothrombin Time
International Normalized Ratio
Control Groups
Bleeding Time
Partial Thromboplastin Time
Apnea
Tertiary Healthcare
Platelet Count

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Association between hypercoagulability and severe obstructive sleep apnea. / Hong, Seung No; Yun, Hee Chul; Yoo, Joon Hyuk; Lee, Seung Hoon.

In: JAMA Otolaryngology - Head and Neck Surgery, Vol. 143, No. 10, 01.10.2017, p. 996-1002.

Research output: Contribution to journalArticle

Hong, Seung No ; Yun, Hee Chul ; Yoo, Joon Hyuk ; Lee, Seung Hoon. / Association between hypercoagulability and severe obstructive sleep apnea. In: JAMA Otolaryngology - Head and Neck Surgery. 2017 ; Vol. 143, No. 10. pp. 996-1002.
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abstract = "IMPORTANCE: Obstructive sleep apnea (OSA) is related to the increased risk of cardiovascular disease. Although the pathogenesis of this association remains unclear, an alteration in coagulability is suspected as a link. OBJECTIVE: To investigate the association between the severity of OSA and blood coagulability. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study conducted at a tertiary care university hospital evaluated 146 patients with OSA from January 1, 2009, to July 31, 2015. The participants were divided into 4 groups according to the severity of OSA: control, mild, moderate, and severe. MAIN OUTCOMES AND MEASURES: Association between the severity of OSA and coagulation test results, including platelet count, bleeding time, prothrombin time (PT) in seconds and as international normalized ratio (INR), and activated partial thromboplastin time. RESULTS: Of the 146 patients, 135 (92.5{\%}) were men; mean (SD) age was 34.8 (11.1) years. The control group included 41 (28.1{\%}) patients; mild OSA, 32 (21.9{\%}); moderate OSA, 30 (20.5{\%}); and severe OSA, 43 (29.5{\%}). Significant correlations were found between the apnea-hypopnea index and the 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). There were significant differences between the OSA severity groups for PT seconds for the control group (mean, 11.26 [0.78] seconds) vs the moderate OSA group (10.74 [0.62] seconds; mean difference [MD], 0.52; 95{\%} CI, 0.27 to 1.01) and the severe OSA group (10.67 [0.77] seconds; MD, 0.59; 95{\%} CI, 0.14 to 1.03). Significant differences were also noted in PT INR between the control group (1.00 [0.07]) vs the moderate OSA group (0.95 [0.05]; MD, 0.04; 95{\%} CI, 0.01 to 0.07) and the severe OSA group (0.94 [0.07]; MD, 0.05; 95{\%} CI, 0.02 to 0.08). However, there was no significant difference between the control and mild OSA groups in PT seconds. CONCLUSIONS AND RELEVANCE: These results suggest that patients with moderate to severe OSA have elevated blood coagulability markers compared with healthy individuals, which may contribute to the occurrence of cardiovascular complications.",
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