Obstructive Sleep Apnea and Venous Thromboembolism

Arnulf, Isabelle; Merino-Andreu, Mila; Perrier, Arnaud; Birolleau, Sophie; Similowski, Thomas; Derenne, Jean‐Philippe

doi:10.1001/jama.287.20.2655

Cited by 55 publications

(40 citation statements)

References 5 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: 62%

“…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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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

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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“…16 Platelet aggregation as well levels of plasminogen activator inhibitor-1 and fibrinogen are increased in SDB patients and decrease after CPAP treatment. 17,18 In addition, hypertensive SDB patients have been noted to have higher levels of thrombin-antithrombin complexes and D-dimer.…”

Section: Hypercoagulability Thrombosis and Sleep-disordered Breathimentioning

confidence: 97%

Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future

2004

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“…Other conditions associated with VTE include autoimmune disorders [167], Behcet's syndrome, celiac disease [184], heparin-induced thrombocytopenia [185], homocystinuria and hyperhomocysteinemia [186,187], hyperthyroidism [188], immune thrombocytopenia (ITP) [189,190], infection [114], inflammatory bowel disease [191], intravascular coagulation and fibrinolysis/disseminated intravascular coagulation (ICF/DIC), myeloproliferative disorders (especially polycythemia rubra vera and essential thrombocythemia) [192,193], chronic kidney disease with severely reduced glomerular filtration rate [194], nephrotic syndrome [195], paroxysmal nocturnal hemoglobinuria [196], rheumatoid arthritis [197,198], obstructive sleep apnea [199,200], thromboangiitis obliterans (Buerger's disease), thrombotic thrombocytopenic purpura, sickle cell disease [201], systemic lupus erythematosus, and granulomatosis with polyangiitis (Wegener's) [202]. Thromboembolic complications associated with L-asparaginase therapy.…”

Section: Questionsmentioning

confidence: 99%

Epidemiology of venous thromboembolism

Ashrani¹,

Heit²

2008

Venous Thromboembolism in Advanced Disease

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Venous thromboembolism (VTE) is categorized by the U.S. Surgeon General as a major public health problem. VTE is relatively common and associated with reduced survival and substantial health-care costs, and recurs frequently. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and VTE risk factors, including increasing patient age and obesity, hospitalization for surgery or acute illness, nursing-home confinement, active cancer, trauma or fracture, immobility or leg paresis, superficial vein thrombosis, and, in women, pregnancy and puerperium, oral contraception, and hormone therapy. Although independent VTE risk factors and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be relatively constant, or even increasing.

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Obstructive Sleep Apnea and Venous Thromboembolism

Cited by 55 publications

References 5 publications

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

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

Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future

Epidemiology of venous thromboembolism

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