B37-09 To Estimate the Prevalence of Obstructive Sleep Apnea and to Correlate the Severity of Obstructive Sleep Apnea With the Monocyte to High Density Lipoprotein Cholesterol Ratio in Patients With Heart Failure in the Indian Population

Abstract Rationale One of the known causes of progression of heart failure is severe nocturnal hypoxemia caused by obstructive sleep apnea, an underlying condition that is commonly associated with heart failure. It is important to recognize OSA as a major contributor to cardiovascular morbidity due to its association with vascular remodeling and endothelial dysfunction. The burden of this disease is fairly high in the Indian population. Quantifying the prevalence of OSA in patients with heart failure will lead to better screening and management of the condition, thus leading to better control of heart failure. The role of a potential plasma biomarker, like the monocyte to HDL cholesterol ratio, to quantify the extent of cardiovascular disease, will further help in screening and stratifying patients according to severity of disease. Methodology The study recruited patients with diagnosed chronic heart failure after obtaining informed consent. They were stratified into three groups based on their ejection fractions - HFrEF (Heart Failure with Reduced Ejection Fraction, EF 40%), HFmrEF (Heart Failure with Mid Range Ejection Fraction, EF - 40-50%) and HFpEF (Heart Failure with Preserved Ejection Fraction, EF 50%). All patients underwent overnight polysomnography to assess for the presence of obstructive sleep apnea. Severity of OSA was defined based on the apnea hypopnea index in accordance with the AASM 2012 guidelines. Fasting blood samples were taken in the morning after polysomnography for laboratory analysis of the monocyte to HDL cholesterol ratio. Results Among the 49 patients who were studied, 5 patients had no OSA, 16 patients (32.6%) had mild OSA, 13 patients (26.5%) had moderate OSA, and 15 patients (30.6%) had severe OSA. The overall prevalence of OSA in patients with heart failure was 91.8 %. The monocyte to HDL cholesterol ratio showed a linear correlation with the AHI. Conclusions This study shows a significant burden of obstructive sleep apnea in patients with heart failure. The monocyte to HDL cholesterol ratio may have a potential role as a serum biomarker to stratify patients according to severity in this population. Further studies from larger and more diverse populations are needed to estimate the true prevalence of the disease and to validate the monocyte to HDL cholesterol ratio as a biomarker to assess severity of OSA. This abstract is funded by: None