Neutrophil-to-Lymphocyte Ratio Facilitates Identification of Obstructive Sleep Apnea in Patients with Type B Aortic Dissection.

Dandan Jiang,Dinghui Wu,Qu Chen,Weiming Su,Theodoros I Vassilakopoulos

doi:10.1155/2021/8492468

Abstract

Purpose To determine whether the neutrophil-to-lymphocyte ratio (NLR) aids in the detection of obstructive sleep apnea (OSA) in patients with type B aortic dissection (TBAD). Methods 324 patients with TBAD or type B aortic intramural hematoma (TB-AIMH) underwent an overnight sleep study. We divided the eligible 256 studied subjects into three groups: group A (n = 109, TBAD patients with OSA), group B (n = 68, TB-AIMH patients with OSA), and group C (n = 79, TBAD patients without OSA). Baseline characteristics, biochemical and sleep parameters, and STOP-Bang questionnaire scores were collected. To assess the predictive efficacy of potential variables, multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used. Results The study found that about 58% of TBAD patients and 54% of TB-AIMH patients had OSA, a majority of whom had moderate to severe OSA (95.41% and 89.71%, respectively). In the comparison of sleep parameters between patients with TBAD and TB-AIMH, no other than apnea and hypopnea index (AHI) made a significant difference. The multivariate logistic regression analysis showed that neutrophil-to-lymphocyte ratio (NLR) (odds ratio (OR): 3.614, 95% confidence interval (CI): 2.273–5.748, and P < 0.05) and STOP-Bang scores (OR: 1.97, 95% CI: 1.34–2.90, and P < 0.05) were both independent predictors for OSA in patients with TBAD. ROC curves showed NLR had higher sensitivity (65% versus 59%) and specificity (86% versus 57%) for OSA than the STOP-Bang questionnaire. Furthermore, NLR was positively correlated with AHI through the Spearman test (r = 0.398 and P < 0.05). Conclusion NLR was an independent predictor of OSA in TBAD patients with higher sensitivity and specificity than the STOP-Bang questionnaire, and it was positively associated with AHI. NLR may aid in the diagnosis and risk stratification of OSA in TBAD patients.

Highlights

Obstructive sleep apnea (OSA) is a common clinical condition characterized by repetitive episodes of apnea or hypopnea with recurrent collapse of the upper airway tract during sleep, resulting in shortened sleep duration and poor sleep quality due to intermittent hypoxia, sleep fragmentation, oxidative stress, and other unclear complex pathophysiological mechanisms [1]
Prevalence of OSA and Demographic Characteristics. e prevalence of OSA in patients with type B aortic dissection (TBAD) reached as high as 58% and 54% of type B aortic intramural hematoma (TB-AIMH) patients were diagnosed as OSA, no significant difference was observed between two groups
OSA was shown to be prevalent in around 58% of patients with TBAD, with the moderate-to-severe type accounting for 95.41% of them

Summary

Introduction

Obstructive sleep apnea (OSA) is a common clinical condition characterized by repetitive episodes of apnea or hypopnea with recurrent collapse of the upper airway tract during sleep, resulting in shortened sleep duration and poor sleep quality due to intermittent hypoxia, sleep fragmentation, oxidative stress, and other unclear complex pathophysiological mechanisms [1]. OSA is associated with various detrimental complications, including cognitive impairment, cardiovascular diseases, pulmonary diseases, endocrine dysfunction, and neuropsychiatric problems [2,3,4], among which cardiovascular diseases are of primary concern due to their higher incidence, acute onset, and poor prognosis. The increasing prevalence and comorbidity of OSA and aortic dissection have captured great attention [5,6,7]. Aortic dissection (AD) is a life-threatening disease and derives from a tear in the intimal layer of the aorta resulting in the entry of blood into the space between the intima and the media, which is usually accompanied by the classic symptom of “severe tear pain.”. Acute aortic syndrome is described as a series of lifethreatening aortic diseases which include aortic intramural

Methods

Results

Conclusion