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Multicenter Study
. 2023 Jan;64(1):48-53.
doi: 10.3349/ymj.2022.0417.

Interactions between Sleep Apnea and Coronary Artery Disease on the Incidence of Sudden Cardiac Arrest: A Multi-Center Case-Control Study

Eujene Jung  1 , Hyun Ho Ryu  1   2 , Young Sun Ro  3 , Kyoung Chul Cha  4 , Sang Do Shin  5 , Sung Oh Hwang  4
Affiliations
Multicenter Study

Interactions between Sleep Apnea and Coronary Artery Disease on the Incidence of Sudden Cardiac Arrest: A Multi-Center Case-Control Study

Eujene Jung et al. Yonsei Med J. 2023 Jan.

Abstract

Purpose: Sleep apnea (SA) is a risk factor for coronary artery disease (CAD), and SA and CAD increase the incidence of sudden cardiac arrest (SCA). This study aimed to investigate the effect of SA on the incidence of SCA and explore the effect of varying degrees of SA with or without CAD on the incidence of SCA.

Materials and methods: This prospective multi-center, case-control study was performed using the phase II Cardiac Arrest Pursuit Trial with Unique Registry and Epidemiologic Surveillance (CAPTURES-II) database for SCA cases and community-based controls in Korea. The matching ratio of cases to controls was 1:1, and they were randomly matched within demographics, including age, sex, and residence. The primary variable was a history of SA, and the second variable was a history of CAD. We conducted a conditional logistic regression analysis to estimate the effect of SA and CAD on the SCA risk, and an interaction analysis between SA and CAD.

Results: SA was associated with an increased risk of SCA [adjusted odds ratio (AOR) (95% confidence interval, CI): 1.54 (1.16-2.03)], and CAD was associated with an increased risk of SCA [AOR (95% CI): 3.94 (2.50-6.18)]. SA was a risk factor for SCA in patients without CAD [AOR (95% CI): 1.62 (1.21-2.17)], but not in patients with CAD [AOR (95% CI): 0.56 (0.20-1.53)].

Conclusion: In the general population, SA is risk factor for SCA only in patients without CAD. Early medical intervention for SA, especially in populations without pre-existing CAD, may reduce the SCA risk. ClinicalTrials.gov (NCT03700203).

Keywords: Sleep apnea; coronary artery disease; risk factors; sudden cardiac arrest.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

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