Abstract
Patients needing surgery for peripheral arterial disease (PAD) represent a severe form of atherosclerosis with an overall five–year mortality of 30 % after revascularisation. The aetiology for poor postoperative clinical outcome in these high-risk patients is not fully established. Obstructive sleep apnoea (OSA) is associated with atherosclerosis and is an independent risk factor for fatal and non-fatal cardiac events. Here we determine the prevalence of undiagnosed OSA in a homogenous group of PAD patients undergoing sub-inguinal surgical revascularisation.
Eighty-two consecutive patients (mean age 67±9, 52 males) with sinus rhythm and without congestive heart failure or previously diagnosed OSA were enrolled for preoperative polysomnography and echocardiography.
OSA was present in 70 (85%) patients (95% confidence interval 75–93%), of whom 24 (34%) had severe OSA. OSA was mostly asymptomatic, and age and gender adjusted multivariate regression analysis showed no relation to obesity, metabolic syndrome or any manifestation of atherosclerosis, other than PAD. Left ventricular ejection fraction (P=0.002) and high density lipoprotein/total cholesterol ratio (P=0.03) were the only independent predictors for the severity of OSA.
Thus, prevalence of OSA is unexpectedly high in patients with PAD and is not related to classical risk factors of sleep apnoea.
- ERS
