Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study

Standard

Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study. / Gessler, Nele; Wohlmuth, Peter; Anwar, Omar; Debus, Eike Sebastian; Eickholt, Christian; Gunawardene, Melanie A; Hakmi, Samer; Heitmann, Kathrin; Rybczynski, Meike; Schueler, Helke; Sheikhzadeh, Sara; Tigges, Eike; Wiest, Gunther H; Willems, Stephan; Adam, Ekaterina; von Kodolitsch, Yskert.

In: EPMA J, Vol. 13, No. 3, 09.2022, p. 451-460.

Research output: SCORING: Contribution to journalSCORING: Journal articleResearchpeer-review

Harvard

Gessler, N, Wohlmuth, P, Anwar, O, Debus, ES, Eickholt, C, Gunawardene, MA, Hakmi, S, Heitmann, K, Rybczynski, M, Schueler, H, Sheikhzadeh, S, Tigges, E, Wiest, GH, Willems, S, Adam, E & von Kodolitsch, Y 2022, 'Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study', EPMA J, vol. 13, no. 3, pp. 451-460. https://doi.org/10.1007/s13167-022-00291-4

APA

Gessler, N., Wohlmuth, P., Anwar, O., Debus, E. S., Eickholt, C., Gunawardene, M. A., Hakmi, S., Heitmann, K., Rybczynski, M., Schueler, H., Sheikhzadeh, S., Tigges, E., Wiest, G. H., Willems, S., Adam, E., & von Kodolitsch, Y. (2022). Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study. EPMA J, 13(3), 451-460. https://doi.org/10.1007/s13167-022-00291-4

Vancouver

Gessler N, Wohlmuth P, Anwar O, Debus ES, Eickholt C, Gunawardene MA et al. Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study. EPMA J. 2022 Sep;13(3):451-460. https://doi.org/10.1007/s13167-022-00291-4

Bibtex

@article{9817942b21e742a1adb46158f8f41da6,
title = "Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study",
abstract = "BACKGROUND: Surgical replacement of the aortic root is the only intervention that can prevent aortic dissection and cardiovascular death in Marfan syndrome (MFS). However, in some individuals, MFS also causes sleep apnea. If sleep apnea predicts cardiovascular death, a new target for predictive, preventive, and personalized medicine (PPPM) may emerge for those individuals with MFS who have sleep apnea.METHODS: This is an investigator-initiated study with long-term follow-up data of 105 individuals with MFS. All individuals were screened for sleep apnea regardless of symptoms. Cardiovascular death served as a primary endpoint, and aortic events as a secondary outcome.RESULTS: Sleep apnea with an apnea-hypopnea index (AHI) > 5/h was observed in 21.0% (22/105) with mild sleep apnea in 13% (14/105) and moderate to severe sleep apnea in 7.6% (8/105). After a median follow-up of 7.76 years (interquartile range: 6.84, 8.41), 10% (10/105) had died, with cardiovascular cause of death in 80% (8/10). After adjusting for age and body mass index (BMI), the AHI score emerged as an independent risk factor for cardiovascular death (hazard ratio 1.712, 95% confidence interval [1.061-2.761], p = 0.0276). The secondary outcome of aortic events occurred in 33% (35/105). There was no effect of the AHI score on aortic events after adjusting for age and BMI (hazard ratio 0.965, 95% confidence interval [0.617-1.509]), possibly due to a high number of patients with prior aortic surgery.INTERPRETATION: Sleep apnea is emerging as an independent predictor of cardiovascular death in MFS. It seems mandatory to screen all individuals with MFS for sleep apnea and to include these individuals, with both MFS and sleep apnea, in further studies to evaluate the impact of preventive measures with regard to cardiovascular death.SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13167-022-00291-4.",
author = "Nele Gessler and Peter Wohlmuth and Omar Anwar and Debus, {Eike Sebastian} and Christian Eickholt and Gunawardene, {Melanie A} and Samer Hakmi and Kathrin Heitmann and Meike Rybczynski and Helke Schueler and Sara Sheikhzadeh and Eike Tigges and Wiest, {Gunther H} and Stephan Willems and Ekaterina Adam and {von Kodolitsch}, Yskert",
note = "{\textcopyright} The Author(s) 2022.",
year = "2022",
month = sep,
doi = "10.1007/s13167-022-00291-4",
language = "English",
volume = "13",
pages = "451--460",
number = "3",

}

RIS

TY - JOUR

T1 - Sleep apnea predicts cardiovascular death in patients with Marfan syndrome:a cohort study

AU - Gessler, Nele

AU - Wohlmuth, Peter

AU - Anwar, Omar

AU - Debus, Eike Sebastian

AU - Eickholt, Christian

AU - Gunawardene, Melanie A

AU - Hakmi, Samer

AU - Heitmann, Kathrin

AU - Rybczynski, Meike

AU - Schueler, Helke

AU - Sheikhzadeh, Sara

AU - Tigges, Eike

AU - Wiest, Gunther H

AU - Willems, Stephan

AU - Adam, Ekaterina

AU - von Kodolitsch, Yskert

N1 - © The Author(s) 2022.

PY - 2022/9

Y1 - 2022/9

N2 - BACKGROUND: Surgical replacement of the aortic root is the only intervention that can prevent aortic dissection and cardiovascular death in Marfan syndrome (MFS). However, in some individuals, MFS also causes sleep apnea. If sleep apnea predicts cardiovascular death, a new target for predictive, preventive, and personalized medicine (PPPM) may emerge for those individuals with MFS who have sleep apnea.METHODS: This is an investigator-initiated study with long-term follow-up data of 105 individuals with MFS. All individuals were screened for sleep apnea regardless of symptoms. Cardiovascular death served as a primary endpoint, and aortic events as a secondary outcome.RESULTS: Sleep apnea with an apnea-hypopnea index (AHI) > 5/h was observed in 21.0% (22/105) with mild sleep apnea in 13% (14/105) and moderate to severe sleep apnea in 7.6% (8/105). After a median follow-up of 7.76 years (interquartile range: 6.84, 8.41), 10% (10/105) had died, with cardiovascular cause of death in 80% (8/10). After adjusting for age and body mass index (BMI), the AHI score emerged as an independent risk factor for cardiovascular death (hazard ratio 1.712, 95% confidence interval [1.061-2.761], p = 0.0276). The secondary outcome of aortic events occurred in 33% (35/105). There was no effect of the AHI score on aortic events after adjusting for age and BMI (hazard ratio 0.965, 95% confidence interval [0.617-1.509]), possibly due to a high number of patients with prior aortic surgery.INTERPRETATION: Sleep apnea is emerging as an independent predictor of cardiovascular death in MFS. It seems mandatory to screen all individuals with MFS for sleep apnea and to include these individuals, with both MFS and sleep apnea, in further studies to evaluate the impact of preventive measures with regard to cardiovascular death.SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13167-022-00291-4.

AB - BACKGROUND: Surgical replacement of the aortic root is the only intervention that can prevent aortic dissection and cardiovascular death in Marfan syndrome (MFS). However, in some individuals, MFS also causes sleep apnea. If sleep apnea predicts cardiovascular death, a new target for predictive, preventive, and personalized medicine (PPPM) may emerge for those individuals with MFS who have sleep apnea.METHODS: This is an investigator-initiated study with long-term follow-up data of 105 individuals with MFS. All individuals were screened for sleep apnea regardless of symptoms. Cardiovascular death served as a primary endpoint, and aortic events as a secondary outcome.RESULTS: Sleep apnea with an apnea-hypopnea index (AHI) > 5/h was observed in 21.0% (22/105) with mild sleep apnea in 13% (14/105) and moderate to severe sleep apnea in 7.6% (8/105). After a median follow-up of 7.76 years (interquartile range: 6.84, 8.41), 10% (10/105) had died, with cardiovascular cause of death in 80% (8/10). After adjusting for age and body mass index (BMI), the AHI score emerged as an independent risk factor for cardiovascular death (hazard ratio 1.712, 95% confidence interval [1.061-2.761], p = 0.0276). The secondary outcome of aortic events occurred in 33% (35/105). There was no effect of the AHI score on aortic events after adjusting for age and BMI (hazard ratio 0.965, 95% confidence interval [0.617-1.509]), possibly due to a high number of patients with prior aortic surgery.INTERPRETATION: Sleep apnea is emerging as an independent predictor of cardiovascular death in MFS. It seems mandatory to screen all individuals with MFS for sleep apnea and to include these individuals, with both MFS and sleep apnea, in further studies to evaluate the impact of preventive measures with regard to cardiovascular death.SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13167-022-00291-4.

U2 - 10.1007/s13167-022-00291-4

DO - 10.1007/s13167-022-00291-4

M3 - SCORING: Journal article

C2 - 36061830

VL - 13

SP - 451

EP - 460

IS - 3

ER -