0705 Association of high risk obstructive sleep apnea with atherosclerotic plaque, coronary stenosis and coronary artery calcium score in asymptomatic young and middle-aged adults in The Miami Heart (MiHeart) Study at Baptist Health South Florida

Abstract

Abstract Introduction Obstructive Sleep Apnea (OSA) is associated with clinical cardiovascular disease (CVD). There are limited data evaluating association with subclinical CVD measured by cardiac computed tomography (CT). We hypothesized there would be significant association between high OSA risk and atherosclerotic plaque, coronary stenosis, and coronary artery calcium (CAC) score in Miami Heart Study cohort free of CVD. Methods Data from CVD free 2359 participants, age 40-65 years (May 2015-Sept 2018) from greater Miami were analyzed. Cardiac CT measured CAC, coronary plaque burden and stenosis. High OSA risk was defined as either OSA diagnosis and/or a high risk from Berlin questionnaire. Logistic regression examined association between high OSA risk (reference low OSA risk) and any plaque, coronary stenosis >50%, and CAC (> 0 and > 100 vs 0) in unadjusted models, and after accounting for age, sex, race/ethnicity (model 2), and BMI, diabetes, high cholesterol, and smoking (model 3). Results 800 (34%) participants had high OSA risk; were more likely to be male, Hispanic, with higher CVD risk factor burden compared to low OSA risk. High OSA risk had higher prevalence of any plaque (60% vs 44%), coronary stenosis ≥ 50% (8.3% vs 4.8%), CAC scores >0-99 (34% vs 26%), and CAC score ≥ 100 (16% vs 12%), compared to low OSA risk (all p < 0.05). High OSA risk was associated with higher odds of any plaque, coronary stenosis ≥ 50%, high-risk plaque features, CAC > 0 and CAC ≥ 100 in univariable models. When adjusting for age, sex and race/ethnicity, these patterns persisted, with 1.58 higher odds of any plaque (95% CI 1.31, 1.91), 1.54 higher odds of coronary stenosis ≥ 50% (95% CI 1.08, 2.20), 1.37 higher odds of having CAC > 0 (95% CI 1.13, 1.66). Associations became non-statistically significant when adjusting for CVD risk factors, except any plaque, which was independently associated after fully adjusted (OR 1.31 (1.05, 1.63). Conclusion Individuals with high risk for OSA, significantly prone for CVD risk factor, have higher likelihood for presence of any plaque, significant stenosis and CAC scores > 0, with these associations mostly mediated by CVD risk factors. Support (If Any) Baptist Health South Florida