Snore much? You’re at risk for aggressive heart disease, study finds

People with obstructive sleep apnea have a higher risk of developing coronary atherosclerosis and coronary artery disease, according to a study presented Tuesday at the annual RSNA meeting.

Obstructive sleep apnea (OSA), a common disorder associated with obesity, occurs when a person’s airway collapses while sleeping, causing him or her to repeatedly stop breathing for 10 seconds or more. Major symptoms of sleep apnea include loud snoring and daytime drowsiness.

Patients with OSA have more noncalcified plaque in their coronary arteries, which puts them at risk for all acute heart events such as heart attacks, unstable angina, and sudden death, said the study’s lead author Dr. U. Joseph Schoepf, a professor of radiology and medicine and director of cardiovascular imaging at the Medical University of South Carolina in Charleston.

The study included 49 obese patients with OSA and 46 obese patients without the condition. Each patient was imaged with coronary CT angiography. All patients had a similar cardiovascular risk.

The correlation between coronary artery disease and sleep apnea was apparent after observing the effect of noncalcified plaque on the study participants. Patients who had OSA did not have a significantly different global calcium score than patients without the disorder. There was, however, a significantly higher prevalence of noncalcified plaque and mixed plaque in patients with OSA. Those patients also had more extensive vessel involvement as well as narrowing in the heart vessels. 

The researchers found 88% of OSA patients had narrowing in at least one vessel, compared with 50% of non-OSA patients. In addition, one-third of OSA patients had narrowing in four vessels, the researchers found.

If this study were performed on a larger scale, coronary CT angiography could be a useful tool for discovering the relationship between coronary artery disease and obstructive sleep apnea. The exam could possibly lead to more aggressive approaches in lipid-lowering therapy as well as lifestyle changes,” Schoepf said.