Key result
Severe nocturnal hypoxemia, indicated by a minimum oxygen saturation ≤90%, was independently associated with a significantly increased risk of coronary microvascular dysfunction (OR 5.89).
Why the study?
A connection exists between OSA and CMD, but the underlying mechanisms remain unclear.
Are nocturnal hypoxemia parameters associated with coronary microvascular dysfunction in hospitalized patients undergoing coronary angiography?
Cross-Sectional (n=133)
Blinded outcome assessment
No
Are nocturnal hypoxemia parameters associated with coronary microvascular dysfunction in hospitalized patients undergoing coronary angiography?
Answers are grounded in this paper and cite their sources.
Nocturnal hypoxemia parameters (minSpO2 ≤ 90% and T90 ≥ 5%) are independently associated with coronary microvascular dysfunction and may be more sensitive indicators of cardiovascular risk than the apnea-hypopnea index.
Objective: There is a connection between obstructive sleep apnea (OSA) and coronary microvascular dysfunction (CMD), but the underlying mechanisms remain unclear. This study aims to evaluate the correlation between OSA-related nocturnal hypoxemia parameters and CMD. Methods: This is an observational, single-center study that included patients who underwent polysomnography and coronary angiography during hospitalization. The presence of CMD was determined by angio-based index of microcirculatory resistance (AccuIMR). Categorical variables were compared using chi-square test or Fisher exact test. The t -test and Mann–Whitney U -test were used to compare normally and non-normally distributed continuous variables, respectively. Univariate and multivariable logistic regression analyses were performed to evaluate the relationship between nocturnal hypoxemia parameters and CMD. Results: A total of 133 patients were included in this study, of whom 72 (54.14%) had evidence of CMD. Patients with CMD exhibited a higher prevalence of OSA and experienced more severe nocturnal hypoxia. After adjusting for potential confounding factors, minimum oxygen saturation (minSpO 2 ) ≤ 90% (OR 5.89; 95% CI 1.73– 19.99; P =0.004) and the percentage of time spent with oxygen saturation below 90% (T90) ≥ 5% (OR 3.13; 95% CI 1.05– 9.38; P =0.041) were independently associated with CMD. However, no significant association was observed between apnea-hypopnea index (AHI) and CMD. Conclusion: Parameters of nocturnal hypoxemia are associated with CMD. Hypoxemia parameters may more sensitively reflect the correlation between OSA and CMD than AHI.
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Feng et al. (2024) conducted a cross-sectional in Coronary Microvascular Dysfunction (n=133). Nocturnal hypoxemia (minSpO2 ≤90%) vs. minSpO2 >90% was evaluated on Presence of coronary microvascular dysfunction (AccuIMR >25U) (OR 5.89, 95% CI 1.73-19.99, p=0.004). Severe nocturnal hypoxemia, indicated by a minimum oxygen saturation ≤90%, was independently associated with a significantly increased risk of coronary microvascular dysfunction (OR 5.89).
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