Obstructive sleep apnea (OSA) is common among patients with coronary artery disease and is associated with obesity, hypertension, diabetes, and heightened sympathetic tone, which increase cardiovascular risk and predispose to arrhythmia. Paradoxically, emerging data from cardiovascular cohorts suggest that patients with OSA and related high-risk phenotypes may exhibit lower short-term mortality in acute cardiac settings, a pattern partly attributed to ischemic preconditioning and the obesity paradox, but data in contemporary PCI populations remain limited.
Nwevo et al. (2026) studied this question. Obstructive sleep apnea is paradoxically associated with lower short-term mortality in acute cardiac settings despite increased arrhythmia risks.