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|Title:||Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men|
Litwack Harrison, S.
|Citation:||European Heart Journal, 2020; 41(4):533-541|
|Publisher:||Oxford University Press|
|Mathias Baumert, Sarah A. Immanuel, Katie L. Stone, Stephanie Litwack Harrison, Susan Redline, Sara Mariani, Prashanthan Sanders, R. Doug McEvoy, and Dominik Linz|
|Abstract:||Aims: To investigate the composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular (CV) mortality in community-dwelling older men. Methods and Results: We analysed overnight oximetry data from polysomnograms obtained in 2840 men from the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study (ClinicalTrials.gov Identifier: NCT00070681) to determine the number of acute episodic desaturations per hour (oxygen desaturation index, ODI) and time spent below 90% oxygen saturation (T90) attributed to acute desaturations (T90desaturation) and to non-specific drifts in oxygen saturation (T90non-specific), respectively, and their relationship with CV mortality. After 8.8 ± 2.7 years follow-up, 185 men (6.5%) died from CV disease. T90 [hazard ratio (HR) 1.21, P < 0.001], but not ODI (HR 1.13, P = 0.06), was significantly associated with CV death in univariate analysis. T90 remained significant when adjusting for potential confounders (HR 1.16, P = 0.004). Men with T90 > 12 min were at an elevated risk of CV mortality (HR 1.59; P = 0.006). Approximately 20.7 (5.7-48.5) percent of the variation in T90 could be attributed to non-specific drifts in oxygen saturation. T90desaturation and T90non-specific were individually associated with CV death but combining both variables did not improve the prediction. Conclusion: In community-dwelling older men, T90 is an independent predictor of CV mortality. T90 is not only a consequence of frank desaturations, but also reflects non-specific drifts in oxygen saturation, both contributing towards the association with CV death. Whether T90 can be used as a risk marker in the clinical setting and whether its reduction may constitute a treatment target warrants further study.|
|Keywords:||Hypoxaemia; cardiovascular; sleep; oximetry; death; mortality|
|Description:||First published online December 2018|
|Rights:||Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: firstname.lastname@example.org.|
|Appears in Collections:||Medicine publications|
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