Severity of Obstructive Sleep Apnea is Positively Associated with the Presence of Carotid Artery Atheromas

Publication date: Available online 20 August 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Tina I. Chang, Urie K. Lee, Michelle R. Zeidler, Stanley Yung Liu, John C. Polanco, Arthur H. Friedlander

Abstract

Objective

Hypoxemia and hypertension caused by obstructive sleep apnea (OSA) often results in atherosclerosis of the carotid and coronary vessels, and heightened risk of stroke and myocardial infarction (MI). Therefore, we sought to determine if severity of OSA, based on the apnea-hypopnea index (AHI), is associated with the presence of calcified carotid artery (atherosclerotic) plaque (CCAP) seen on panoramic images (PIs).

Study Design

Utilizing a cross-sectional study design, we reviewed the electronic medical records (EMRs) and PIs of all male patients referred from the Sleep Medicine Service to the Dental Service between 2010 and 2016. The predictor variable was the was the individuals' OSA intensity level as defined by the American Academy of Sleep Medicine based on the AHI score. The outcome variable was the presence of CCAP on the PI. Other variables of interest, that is, demographic and atherogenic risk factors: age, body mass index, diabetes, hypertension, and hyperlipidemia, were included in a multivariate analysis to assess association of OSA with CCAP.

Results

The study sample consisted of 108 subjects (mean age 54.7 ± 13.5). Approximately 1/3 of individuals (N = 33, 30.6%) presented with CCAP and this group was significantly older, and with greater odds of co-diagnosis of diabetes (P < 0.05). Subjects with more "severe" OSA demonstrated significantly greater odds of demonstrating CCAP on their PIs as compared to those with "milder" OSA (OR: 1.035, 95% CI: 1.008 – 1.062, P = 0.010) when adjusted for confounders.

Conclusion

There is a strong association between severity of OSA and the presence of CCAP that can be seen on PI. These atherosclerotic plaques are "risk factors" for stroke and "risk indicators" for future MI; therefore, clinicians providing corrective airway surgery for these patients and noting concomitant CCAP on PI, should refer them for a thorough cerebrovascular and cardiovascular work-up.

https://ift.tt/2vZOJXd