Key result
The presence of sleep apnea-COPD overlap syndrome in COPD patients was an independent predictor of left carotid atherosclerotic plaques (OR 4.54) and was associated with significantly larger plaque volumes.
Why the study?
Little is known about whether overlap syndrome combining COPD and sleep apnea-hypopnea syndrome increases the stroke risk associated with COPD itself.
Does the presence of sleep apnea-COPD overlap syndrome increase the prevalence and volume of carotid atherosclerotic plaques in COPD patients?
Cross-Sectional (n=106)
No
Does the presence of sleep apnea-COPD overlap syndrome increase the prevalence and volume of carotid atherosclerotic plaques in COPD patients?
Odds Ratio: 4.54 (95% CI 1.39–14.85)
Absolute Event Rate: 79% vs 50%
p-value: p=0.012
The presence of sleep apnea-COPD overlap syndrome is associated with larger left carotid atherosclerotic plaques, suggesting these patients may be at higher risk for stroke and could benefit from screening.
Should not yet change practice; leaves open whether OS screening identifies COPD patients at higher stroke risk.
Background Little is known about whether the overlap syndrome (OS) combining features of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome increases the risk of stroke associated with COPD itself. Methods We prospectively studied 74 COPD patients and 32 subjects without lung disease. Spirometry and cardiorespiratory polygraphy were used to assess the pulmonary function of the study population and ultrasound measurements of intima media thickness (IMT) as well as the volume of plaques in both carotid arteries were also evaluated. Results Polygraphic criteria of OS were met in 51% of COPD patients. We found that 79% of patients with OS and 50% of COPD patients without OS had atherosclerotic plaques in the left carotid artery ( p = 0.0509). Interestingly, the mean volume of atherosclerotic plaques was significantly higher in the left carotid artery of COPD patients with OS (0.07 ± 0.02 ml) than in those without OS (0.04 ± 0.02 ml, p = 0.0305). However, regardless of the presence of OS, no significant differences were observed in both presence and volume of atherosclerotic plaques in the right carotid artery of COPD patients. Adjusted-multivariate linear regression revealed age, current smoking and the apnea/hypopnea index (OR = 4.54, p = 0.012) as independent predictors of left carotid atherosclerotic plaques in COPD patients. Conclusions This study suggests that the presence of OS in COPD patients is associated with larger left carotid atherosclerotic plaques, indicating that OS might be screened in all COPD patients to identify those with higher risk of stroke.
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Landete et al. (2023) conducted a cross-sectional in Chronic obstructive pulmonary disease (COPD) and sleep apnea-COPD overlap syndrome (OS) (n=106). Sleep apnea-COPD overlap syndrome (AHI ≥ 5) vs. COPD without overlap syndrome (AHI < 5) was evaluated on Presence of left carotid atherosclerotic plaques (OR 4.54, 95% CI 1.39-14.85, p=0.012). The presence of sleep apnea-COPD overlap syndrome in COPD patients was an independent predictor of left carotid atherosclerotic plaques (OR 4.54) and was associated with significantly larger plaque volumes.
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