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[PMID]: | 28817760 |
[Au] Autor: | Hong SN; Yun HC; Yoo JH; Lee SH |
[Ad] Endereço: | Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea. |
[Ti] Título: | Association Between Hypercoagulability and Severe Obstructive Sleep Apnea. |
[So] Source: | JAMA Otolaryngol Head Neck Surg;143(10):996-1002, 2017 Oct 01. | [Is] ISSN: | 2168-619X |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | 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. |
[Mh] Termos MeSH primário: |
Apneia Obstrutiva do Sono/sangue Apneia Obstrutiva do Sono/complicações Trombofilia/etiologia
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[Mh] Termos MeSH secundário: |
Adulto Tempo de Sangramento Testes de Coagulação Sanguínea Feminino Seres Humanos Masculino Meia-Idade Contagem de Plaquetas Polissonografia Estudos Retrospectivos Fatores de Risco Índice de Gravidade de Doença Apneia Obstrutiva do Sono/fisiopatologia Trombofilia/diagnóstico Trombofilia/fisiopatologia Adulto Jovem
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[Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Em] Mês de entrada: | 1710 |
[Cu] Atualização por classe: | 171031 |
[Lr] Data última revisão:
| 171031 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 170818 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1001/jamaoto.2017.1367 |
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