Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study. / Linz, Dominik; Loffler, Kelly A.; Sanders, Prashanthan; Catcheside, Peter; Anderson, Craig S.; Zheng, Danni; Quan, WeiWei; Barnes, Mary; Redline, Susan; McEvoy, R. Doug; Baumert, Mathias; SAVE Sleep Apnea Cardiovasc Endpoi.

In: Chest, Vol. 158, No. 6, 2020, p. 2621-2631.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Linz, D, Loffler, KA, Sanders, P, Catcheside, P, Anderson, CS, Zheng, D, Quan, W, Barnes, M, Redline, S, McEvoy, RD, Baumert, M & SAVE Sleep Apnea Cardiovasc Endpoi 2020, 'Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study', Chest, vol. 158, no. 6, pp. 2621-2631. https://doi.org/10.1016/j.chest.2020.06.072

APA

Linz, D., Loffler, K. A., Sanders, P., Catcheside, P., Anderson, C. S., Zheng, D., Quan, W., Barnes, M., Redline, S., McEvoy, R. D., Baumert, M., & SAVE Sleep Apnea Cardiovasc Endpoi (2020). Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study. Chest, 158(6), 2621-2631. https://doi.org/10.1016/j.chest.2020.06.072

Vancouver

Linz D, Loffler KA, Sanders P, Catcheside P, Anderson CS, Zheng D et al. Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study. Chest. 2020;158(6):2621-2631. https://doi.org/10.1016/j.chest.2020.06.072

Author

Linz, Dominik ; Loffler, Kelly A. ; Sanders, Prashanthan ; Catcheside, Peter ; Anderson, Craig S. ; Zheng, Danni ; Quan, WeiWei ; Barnes, Mary ; Redline, Susan ; McEvoy, R. Doug ; Baumert, Mathias ; SAVE Sleep Apnea Cardiovasc Endpoi. / Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study. In: Chest. 2020 ; Vol. 158, No. 6. pp. 2621-2631.

Bibtex

@article{3bc822786baf46eb8927cf094e91026c,
title = "Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study",
abstract = "BACKGROUND: Traditional methods for the quantification of OSA severity may not encapsulate potential relationships between hypoxemia in OSA and cardiovascular risk.RESEARCH QUESTION: Do novel nocturnal oxygen saturation (Spo(2)) metrics have prognostic value in patients with OSA and high cardiovascular event risk?STUDY DESIGN AND METHODS: We conducted post hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial. In 2687 individuals, Cox proportional hazards models that were stratified for treatment allocation were used to determine the associations between clinical characteristics, pulse oximetry-derived metrics that were designed to quantify sustained and episodic features of hypoxemia, and cardiovascular outcomes. Metrics included oxygen desaturation index, timeRESULTS: Neither apnea-hypopnea index, oxygen desaturation index, nor any of the novel Spo(2) metrics were associated with the primary SAVE composite cardiovascular outcome. Mean and baseline Spo(2) were associated with heart failure (hazard ratio [HR], 0.81; 95% CI, 0.69-0.95; P = .009; and HR, 0.78; 95% CI, 0.67-0.90; P = .001, respectively) and myocardial infarction (HR, 0.86; 95% CI, 0.77-0.95; P = .003; and HR, 0.81; 95% CI, 0.73-0.90; P <.001, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted future heart failure (area under the curve, 0.86; 95% CI, 0.79-0.93).INTERPRETATION: Apnea-hypopnea index and oxygen desaturation index were not associated with cardiovascular outcomes. In contrast, the pattern of oxygen desaturation was associated with heart failure and myocardial infarction. However, concomitant risk factors remained the predominant determinants for secondary cardiovascular events and thus deserve the most intensive management.",
keywords = "cardiovascular risk, heart failure, hypoxemia, SAVE, sleep apnea, OBSTRUCTIVE SLEEP-APNEA, POSITIVE AIRWAY PRESSURE, HEART-FAILURE, DISEASE, ASSOCIATION, HYPOPNEA",
author = "Dominik Linz and Loffler, {Kelly A.} and Prashanthan Sanders and Peter Catcheside and Anderson, {Craig S.} and Danni Zheng and WeiWei Quan and Mary Barnes and Susan Redline and McEvoy, {R. Doug} and Mathias Baumert and {SAVE Sleep Apnea Cardiovasc Endpoi}",
year = "2020",
doi = "10.1016/j.chest.2020.06.072",
language = "English",
volume = "158",
pages = "2621--2631",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "6",

}

RIS

TY - JOUR

T1 - Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk Post Hoc Analyses of the SAVE Study

AU - Linz, Dominik

AU - Loffler, Kelly A.

AU - Sanders, Prashanthan

AU - Catcheside, Peter

AU - Anderson, Craig S.

AU - Zheng, Danni

AU - Quan, WeiWei

AU - Barnes, Mary

AU - Redline, Susan

AU - McEvoy, R. Doug

AU - Baumert, Mathias

AU - SAVE Sleep Apnea Cardiovasc Endpoi

PY - 2020

Y1 - 2020

N2 - BACKGROUND: Traditional methods for the quantification of OSA severity may not encapsulate potential relationships between hypoxemia in OSA and cardiovascular risk.RESEARCH QUESTION: Do novel nocturnal oxygen saturation (Spo(2)) metrics have prognostic value in patients with OSA and high cardiovascular event risk?STUDY DESIGN AND METHODS: We conducted post hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial. In 2687 individuals, Cox proportional hazards models that were stratified for treatment allocation were used to determine the associations between clinical characteristics, pulse oximetry-derived metrics that were designed to quantify sustained and episodic features of hypoxemia, and cardiovascular outcomes. Metrics included oxygen desaturation index, timeRESULTS: Neither apnea-hypopnea index, oxygen desaturation index, nor any of the novel Spo(2) metrics were associated with the primary SAVE composite cardiovascular outcome. Mean and baseline Spo(2) were associated with heart failure (hazard ratio [HR], 0.81; 95% CI, 0.69-0.95; P = .009; and HR, 0.78; 95% CI, 0.67-0.90; P = .001, respectively) and myocardial infarction (HR, 0.86; 95% CI, 0.77-0.95; P = .003; and HR, 0.81; 95% CI, 0.73-0.90; P <.001, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted future heart failure (area under the curve, 0.86; 95% CI, 0.79-0.93).INTERPRETATION: Apnea-hypopnea index and oxygen desaturation index were not associated with cardiovascular outcomes. In contrast, the pattern of oxygen desaturation was associated with heart failure and myocardial infarction. However, concomitant risk factors remained the predominant determinants for secondary cardiovascular events and thus deserve the most intensive management.

AB - BACKGROUND: Traditional methods for the quantification of OSA severity may not encapsulate potential relationships between hypoxemia in OSA and cardiovascular risk.RESEARCH QUESTION: Do novel nocturnal oxygen saturation (Spo(2)) metrics have prognostic value in patients with OSA and high cardiovascular event risk?STUDY DESIGN AND METHODS: We conducted post hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial. In 2687 individuals, Cox proportional hazards models that were stratified for treatment allocation were used to determine the associations between clinical characteristics, pulse oximetry-derived metrics that were designed to quantify sustained and episodic features of hypoxemia, and cardiovascular outcomes. Metrics included oxygen desaturation index, timeRESULTS: Neither apnea-hypopnea index, oxygen desaturation index, nor any of the novel Spo(2) metrics were associated with the primary SAVE composite cardiovascular outcome. Mean and baseline Spo(2) were associated with heart failure (hazard ratio [HR], 0.81; 95% CI, 0.69-0.95; P = .009; and HR, 0.78; 95% CI, 0.67-0.90; P = .001, respectively) and myocardial infarction (HR, 0.86; 95% CI, 0.77-0.95; P = .003; and HR, 0.81; 95% CI, 0.73-0.90; P <.001, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted future heart failure (area under the curve, 0.86; 95% CI, 0.79-0.93).INTERPRETATION: Apnea-hypopnea index and oxygen desaturation index were not associated with cardiovascular outcomes. In contrast, the pattern of oxygen desaturation was associated with heart failure and myocardial infarction. However, concomitant risk factors remained the predominant determinants for secondary cardiovascular events and thus deserve the most intensive management.

KW - cardiovascular risk

KW - heart failure

KW - hypoxemia

KW - SAVE

KW - sleep apnea

KW - OBSTRUCTIVE SLEEP-APNEA

KW - POSITIVE AIRWAY PRESSURE

KW - HEART-FAILURE

KW - DISEASE

KW - ASSOCIATION

KW - HYPOPNEA

U2 - 10.1016/j.chest.2020.06.072

DO - 10.1016/j.chest.2020.06.072

M3 - Journal article

C2 - 32679239

VL - 158

SP - 2621

EP - 2631

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -

ID: 256885538