Abstract 17346: The Causal Role of Obstructive Sleep Apnea (OSA) in Atrial Fibrillation (AF): A Systematic Review and Meta-Analysis of Mendelian Randomization Studies

Abstract

Background: Atrial fibrillation (AF) causes significant morbidity and mortality. Obstructive sleep apnea (OSA) has been suggested as a risk factor for AF, but the causal relationship between the two is still being investigated. We performed a systematic review and meta-analysis of Mendelian Randomization (MR) studies to determine OSA's role in AF. Methods: We searched PubMed, Scopus, Embase, and Google Scholar databases for MR studies on the causal relationship between OSA and AF through June 2023. Our analysis included eligible studies. The pooled odds ratio and subgroup analysis were calculated using the random-effects model. The I2 statistic was used to assess study heterogeneity, and a leave-one-out sensitivity analysis was performed to determine how individual studies affected the overall estimate and analysis robustness. Results: 5 MR studies met our inclusion criteria until June 2023. In these studies, one used diverse datasets and included patient data of 5 cohorts with UK, Canada, Australia, USA, Finland ancestry while the remaining 4 included patient data of European ancestry. Genetic predisposition to OSA was found to cause AF in the pooled odds ratio analysis (OR 1.21, 95% CI 1.15-1.28, I2=0.00%, p <0.01). The leave-one-out sensitivity analysis showed that the odds ratio marginally changed when specific studies were excluded, suggesting that their contribution to the estimate slightly differed. Conclusion: Our findings suggest a causal relationship between OSA and AF, suggesting that OSA may cause AF. The findings emphasize the need for early evaluation and treatment of AF patients with OSA. However, large-scale prospective studies are required to confirm these findings and determine their clinical practice implications.