Association Between Obstructive Sleep Apnea and Pulmonary Embolism

Alonso-Fernández, Alberto; Peña, Mónica de la; Romero, David; Piérola, Javier; Carrera, Miguel; Barceló, Antònia; Soriano, Joan B.; Suquia, Angela García; Fernández‐Capitán, Carmen; Lorenzo, Alicia; García‐Río, Francisco

doi:10.1016/j.mayocp.2013.02.005

Cited by 46 publications

(28 citation statements)

References 37 publications

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“…There is increasing evidence from cross-sectional and longitudinal studies, that OSA is an independent risk factor for PE [1][2][3][4][5]. We have recently shown in a group of 107 PE patients significantly higher prevalence in all OSA severity groups when compared with controls.…”

Section: Discussionmentioning

confidence: 61%

“…From the 107 patients with PE and the 102 control subjects [1] we excluded 21 PE patients, who were on vitamin K antagonist, and 13 control subjects, who were without blood samples. All patients were under oral anticoagulation with acenocoumarol.…”

Section: Resultsmentioning

confidence: 99%

“…The adjusted OR using AHI as a continuous variable was 1.038, which indicated that for every 10-unit rise in AHI, PE risk increased by 45% [1].…”

Section: Discussionmentioning

confidence: 98%

“…Data from new studies are needed to definitively clarify if OSA is a risk factor for PE recurrence, particularly in those ones with high D-dimer values. Given the high prevalence of OSA in PE patients [1][2][3][4][5], the increased blood coagulability induced by OSA, and the raised percentage of patients with elevated D-dimer levels after the completion of anticoagulation, the potential of CPAP and/or resumption anticoagulant drugs to reduce incidence and mortality in patients with OSA clearly warrants further study, in particular for patients with previous PE.…”

Section: Discussionmentioning

confidence: 99%

“…There is increasing evidence from cross-sectional and longitudinal studies that obstructive sleep apnoea (OSA) is a risk factor for pulmonary embolism (PE) independent of potential confounders [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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High D-dimer levels after stopping anticoagulants in pulmonary embolism with sleep apnoea

et al. 2015

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Obstructive sleep apnoea is a risk factor for pulmonary embolism. Elevated D-dimer levels and other biomarkers are associated with recurrent pulmonary embolism. The objectives were to compare the frequency of elevated D-dimer levels (>500 ng·mL ) and further coagulation biomarkers after oral anticoagulation withdrawal in pulmonary embolism patients, with and without obstructive sleep apnoea, including two control groups without pulmonary embolism.We performed home respiratory polygraphy. We also measured basic biochemical profile and haemogram, and coagulation biomarkers (D-dimer, prothrombin fragment 1+2, thrombin-antithrombin complex, plasminogen activator inhibitor 1, and soluble P-selectin).64 (74.4%) of the pulmonary embolism cases and 41 (46.11%) of the controls without pulmonary embolism had obstructive sleep apnoea. Plasmatic D-dimer was higher in PE patients with OSA than in those without obstructive sleep apnoea. D-dimer levels were significantly correlated with apnoeahypopnoea index, and nocturnal hypoxia. There were more patients with high D-dimer after stopping anticoagulants in those with pulmonary embolism and obstructive sleep apnoea compared with PE without obstructive sleep apnoea (35.4% versus 19.0%, p=0.003). Apnoea-hypopnoea index was independently associated with high D-dimer.Pulmonary embolism patients with obstructive sleep apnoea had higher rates of elevated D-dimer levels after anticoagulation discontinuation for pulmonary embolism than in patients without obstructive sleep apnoea and, therefore, higher procoagulant state that might increase the risk of pulmonary embolism recurrence. @ERSpublications Pulmonary embolism patients with sleep apnoea are more likely to have elevated postanticoagulation plasma D-dimer

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