Nonlinear Relationship Between Chinese Visceral Adiposity Index and New-Onset Myocardial Infarction in Patients with Hypertension and Obstructive Sleep Apnoea: Insights from a Cohort Study

Abstract

We aimed to investigate the relationship between the Chinese visceral adiposity index (CVAI) and the risk of new-onset myocardial infarction (MI) in patients with hypertension and obstructive sleep apnoea (OSA) and to inspect possible modifiers of the effect. Methods: The Cox regression model was used to evaluate the relationship between baseline CVAI and risk of new-onset MI. A generalized additive model was used to identify the nonlinear relationship. Besides, we conducted subgroup analyses and interaction tests. Results: A total of 2177 patients with hypertension and OSA undergoing polysomnography were enrolled in this study. During a median follow-up period of 87 months, 82 participants developed new-onset MI. Overall, CVAI was positively related to the risk of new-onset MI (per 1 SD increase; HR = 1.54, 95% CI: 1.28-1.85). In multivariable-adjusted models, the risk of new-onset MI increased with quartiles of CVAI, with an HR of 3.64 (95% CI: 1.94-6.83) for quartile 4 compared with quartile 1. The generalized additive model and smoothed curve fit revealed a nonlinear relationship between CVAI and risk of new-onset MI with an inflection point of approximately 112. None of the stratification variables had a significant effect on the relationship between CVAI and newonset MI. Similar outcomes were observed in the sensitivity analysis. The addition of CVAI significantly improved reclassification and discrimination over the conventional model, with a category-free NRI of 0.132 (95% CI 0.021 to 0.236, P = 0.021) and an IDI of 0.012 (95% CI 0.005 to 0.023, P < 0.001). Conclusion:This study demonstrated a nonlinear relationship between CVAI and the risk of new-onset MI in patients with hypertension and OSA. Higher CVAI was significantly associated with the risk of new-onset MI when CVAI was ≥112.

Associations of the Cardiometabolic Index with the Risk of Cardiovascular Disease in Patients with Hypertension and Obstructive Sleep Apnea: Results of a Longitudinal Cohort Study

“…Baseline data collection was expected to be completed by professional research staff following the operational procedures mentioned in previous studies [ 33 ]. One-on-one interviews were held with each participant using a standardized electronic medical record.…”

“…Study Population. All data were obtained from the URO-SAH study, and a detailed description of the UROSAH study has been reported elsewhere [33]. In brief, UROSAH is a single-center, observational, retrospective cohort study designed to investigate the relationship between long-term cardiovascular outcomes in patients with hypertension and OSA.…”

Association Between Triglyceride Glucose Index-Waist Circumference and Risk of First Myocardial Infarction in Chinese Hypertensive Patients with Obstructive Sleep Apnoea: An Observational Cohort Study

“…Details of the study design have been previously described. 38 Briefly, a total of 3605 hypertensive patients aged >18 years with suspected OSA agreed to participate and completed the first survey from January 2011 to December 2013. A total of 276 cases were lost to follow-up, and the rate of loss to follow-up was 7.66%.…”

“…Regular CPAP treatment was defined as >70% of the average treatment time ≥4 hours/night throughout the follow-up period, or an average of ≥4 hours per night (CPAP devices were only available for cumulative hours of use). 38–40 …”

Development and Validation of a Coronary Heart Disease Risk Prediction Model in Snorers with Hypertension: A Retrospective Observed Study

“…Written informed consent was submitted by all patients or their legal relatives participating in this study. 26 …”