Key result
Record-based hypoxic burden linked to an ~83% higher risk of cardiovascular mortality.
Why the study?
Respiratory event-related oxygen desaturation area measures are novel predictors of CVD outcomes, but how different methods for calculating the SpO2 baseline in hypoxic burden algorithms affect cardiovascular mortality prediction was unknown.
Does calculating hypoxic burden using a record-based baseline improve the prediction of cardiovascular mortality compared to the pre-event baseline method in adults?
Cohort (n=4,686)
Yes
Does calculating hypoxic burden using a record-based baseline improve the prediction of cardiovascular mortality compared to the pre-event baseline method in adults?
A simplified record-based baseline method for calculating hypoxic burden from pulse oximetry is a significant independent predictor of cardiovascular mortality, outperforming the traditional pre-event baseline method.
May support simplified hypoxic burden for CV mortality prediction; leaves open prospective validation versus standard methods.
Respiratory event related oxygen desaturation area measures have recently shown merit as novel predictors of cardiovascular disease (CVD) outcomes. In this study, we investigate one such measure (hypoxic burden (HB)) and investigate how three different ways of calculating the SpO2 baseline of the HB algorithm impact its ability to predict cardiovascular mortality. The three baseline estimation steps include a pre-event baseline, a record-based baseline, and a fixed baseline. Pulse oximetry signals from the Sleep Heart Health Study and the corresponding CVD outcomes were analyzed. The performance of each baseline method was compared using adjusted Cox proportional hazard regression analysis. Results show that HB with the record-based baseline method returned the best performing results with a hazard ratio (HR) of 1.83 (95% CI: 1.03-3.27, p<0.05) in the fully adjusted model, compared to HB with the pre-event baseline method (HR: 1.60, 95%CI: 0.86-3.00, p>0.05) and HB with the fixed baseline method (HR: 1.73, 95%CI: 0.93-3.22, p>0.05).
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He et al. (2023) conducted a cohort in Cardiovascular disease (n=4,686). Hypoxic burden (HB) with record-based baseline vs. HB with pre-event baseline and HB with fixed baseline was evaluated on Cardiovascular mortality (HR 1.83, 95% CI 1.03-3.27, p=0.04). Hypoxic burden calculated using a record-based baseline method significantly predicted cardiovascular mortality with a hazard ratio of 1.83 in a fully adjusted model.
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