Key result
Three-protein panel predicts recurrent cardiovascular events in severe OSA with an AUC of ~0.81.
Why the study?
The pathological pathways by which obstructive sleep apnea promotes recurrent cardiovascular event risk in patients with first acute coronary syndrome are unknown.
Does proteomic profiling predict recurrent cardiovascular events in patients with acute coronary syndrome and severe obstructive sleep apnea?
Observational (n=86)
Blinded
Yes
Does proteomic profiling predict recurrent cardiovascular events in patients with acute coronary syndrome and severe obstructive sleep apnea?
Effect estimate: AUC 0.81 (95% CI 0.71-0.9)
A specific proteomic profile can predict recurrent cardiovascular events in patients with ACS and severe OSA, potentially aiding in risk stratification.
May support proteomic risk stratification in severe OSA; hypothesis-generating for ACS patients and requires prospective validation before clinical use.
BACKGROUND: Obstructive sleep apnea (OSA) is associated with a recurrent cardiovascular event (CVE) risk in patients with a first acute coronary syndrome (ACS). However, the pathological pathways by which OSA promotes this deleterious role are unknown. We aim to explore the proteomic profile associated with OSA that promote the recurrent CVE risk in severe OSA patients with ACS without previous cardiovascular diseases. METHODS: This post-hoc analysis from the ISAACC study (NCT01335087) included 86 patients admitted for ACS. Patients underwent respiratory polygraphy for the first 24-72 h to OSA diagnosis. We analyzed of 276 cardiovascular and inflammatory related proteins in baseline fasting plasma samples using proximity expression assay technology (Olink®, Sweden). Protein levels were compared between severe OSA patients with/without recurrent CVEs during follow-up. Random forest was conducted to select relevant proteins and generate a predictive model of recurrent CVE. RESULTS: and 86 % males) admitted for ACS with severe OSA (56 without recurrent CVE/30 with recurrent CVE). The plasma levels of 38 proteins were differentially expressed between groups. Additionally, 12 proteins had a significant association with respiratory polygraphy parameters. Three proteins discriminate with an AUC of 0.81 (95 % CI of 0.71-0.9) between severe OSA patients with and without recurrent CVE. These proteins were implicated in cell proliferation, communication and apoptosis, and regulation/response to the inflammatory and immune systems. CONCLUSION: In ACS patients with severe OSA, a proteomic profile was associated with recurrent CVEs. This proteomic profile was correlated with specific OSA parameters from respiratory polygraphy. Proteomic profiling may provide an new direction for patient risk stratification and clinical management.
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Zapater et al. (2022) conducted an observational in Acute coronary syndrome and severe obstructive sleep apnea (n=86). Proteomic profiling (CXCL16, STK4, and TFPI) vs. Patients without recurrent cardiovascular events was evaluated on Discrimination of recurrent cardiovascular events (AUC 0.81, 95% CI 0.71-0.9). A predictive model based on three plasma proteins (CXCL16, STK4, and TFPI) discriminated between severe obstructive sleep apnea patients with and without recurrent cardiovascular events with an AUC of 0.81.
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