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. 2022 Jan 4;20(1):1.
doi: 10.1186/s12959-021-00358-8.

Association between obstructive sleep apnea and venous thromboembolism recurrence: results from a French cohort

Olivier Nepveu  1   2 , Charles Orione  1   2 , Cécile Tromeur  1   2 , Alexandre Fauché  1   2 , Cecile L'heveder  1   2 , Marie Guegan  1   2 , Catherine Lemarié  1   2 , David Jimenez  3 , Christophe Leroyer  1   2 , Karine Lacut  1   2 , Francis Couturaud  1   2 , Raphael Le Mao  4   5
Affiliations

Association between obstructive sleep apnea and venous thromboembolism recurrence: results from a French cohort

Olivier Nepveu et al. Thromb J. .

Abstract

Background: Growing evidence suggests the relationship between obstructive sleep apnea (OSA) and venous thromboembolism (VTE). Few studies focused on VTE recurrence risk associated with OSA after anticoagulation cessation.

Methods: In a prospective cohort study, patients with documented VTE, were followed for an indefinite length of time and VTE recurrence were documented and adjudicated. The primary outcome was recurrent VTE after anticoagulation discontinuation. Secondary outcomes included all-cause mortality and the clinical presentation of VTE. Univariable and multivariable analyses were performed to identify risk factors for recurrence and mortality.

Results: Among the 2109 patients with documented VTE included, 74 patients had moderate to severe OSA diagnosis confirmed by home sleep test or polysomnography. During a median follow-up of 4.8 (interquartile range 2.5-8.0) years recurrent VTE occurred in 252 patients (9 with OSA and 243 without OSA). The recurrence risk in the univariable and multivariable analysis was not increased in patients with OSA, regardless of the time of diagnosis (before or after index VTE or pooled). VTE phenotype was significantly more often PE with or without associated deep vein thrombosis in the first event and recurrence for OSA patients compared to non-OSA patients. The risk of death was not increased in the OSA population compared to non-OSA patients in multivariable analysis.

Conclusions: In patients with OSA and VTE, the risk of all-cause mortality and VTE recurrence after anticoagulation discontinuation was not increased compared to non-OSA patients.

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Conflict of interest statement

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr. Nepveu declares he has no competing interests related to this research. Dr. Orione declares he has no competing interests related to this research. Dr. Tromeur declares she has no competing interests related to this research. Dr. L’heveder declares she has no competing interests related to this research. Ms. Guegan declares she has no competing interests related to this research. Dr. Lemarié declares she has competing interests related to this research. Dr. Fauché declares he has competing interests related to this research. Dr. Jimenez declares he has no competing interests related to this research. Dr. Leroyer reports having received research grant support from Pfizer and fees for board memberships or symposia from Bayer and Astra Zeneca and having received travel support from Bayer, Daiichi Sankyo, Leo Pharma, Intermune and Actelion. Dr. Lacut reports having received personal fees from Bayer-Health Care, Bristol-Myers Squibb and Boehringer Ingelheim. Dr. Couturaud reports having received research grant support from Pfizer and fees for board memberships or symposia from Bayer, Bristol-Myers Squibb/Pfizer and Astra Zeneca and having received travel support from Bayer, Bristol-Myers Squibb/Pfizer, Daiichi Sankyo, Boehringer Ingelheim, Leo Pharma, Intermune and Actelion. Dr. Le Mao declares he has no conflict of interest related to this research.

Figures

Fig. 1
Fig. 1
Flow chart. OSA, Obstructive Sleep Apnea; VTE, Venous Thromboembolism
See this image and copyright information in PMC

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