Abstract P365: Restless Leg Symptoms Predicts Adverse Cardiovascular Outcomes in Patients Undergoing Cardiac Catheterization

Abstract

Introduction: The association between restless leg syndrome (RLS) and CV outcomes remains controversial in the general population, and the impact of RLS among patients with coronary artery disease (CAD) is unknown. Hypothesis: We examined our hypothesis that RLS symptoms would be associated with incident adverse CV outcomes in patients with CAD. Methods: We inquired about the presence and frequency of RLS symptoms in 3,176 patients enrolled in the Emory Cardiovascular Biobank (mean age 64, 62% male, 23% Black, and 75% with obstructive CAD), who were prospectively followed for death, myocardial infarction (MI), revascularization, and hospitalization for heart failure (HF). Multivariate Cox proportional hazard models were used to examine the association between RLS symptoms and adverse outcomes after adjustment for demographic and clinical risk factors. Results: Of the total, 914 (28.8%) and 482 (15.2%) patients reported mild (rare or sometimes) and moderate/severe (often to almost always) symptoms of RLS, respectively. Female sex (Odds ratio [OR] 2.11, P<0.001), higher body mass index (OR 1.12 per 5kg/m2, P=0.007), diabetes (OR 1.43, P=0.003), and beta blocker use (OR 1.35, P=0.013) were independently associated with moderate-severe symptoms of RLS compared to no symptoms. During a median 3.2-year follow-up, 991 patients suffered at least1 adverse event. Those with moderate/severe symptoms had significantly higher adjusted risk of death/MI (Hazard ratio [HR] 1.30 [1.02 - 1.66]), death/MI/revascularization (HR 1.22 [1.02 - 1.45]), and death/MI/revascularization/hospitalization for HF (HR 1.23 [1.04 - 1.45]). Those with mild symptoms had similar risks to those with no symptoms. Conclusions: Among patients undergoing cardiac catheterization, moderate or severe symptoms of RLS are associated with significantly higher risk of adverse CV outcomes, independent of traditional risk factors. This is the first study to demonstrate an independent adverse impact of RLS symptoms in CAD patients.