Year: 2023
Type: conference-abstract
Abstract: Introduction Obstructive sleep apnea (OSA) affects pathways implicated in the pathophysiology of cardiovascular disease (CVD) by poorly understood mechanisms. Platelets are key mediators of CVD risk and thrombosis and prior studies have suggested associations with OSA. We hypothesized that markers of OSA and platelet activity may be linked, and that these associations may be influenced by CVD risk factors. Methods Using one of the largest repositories of sleep phenotyping and platelet aggregation data available, we assessed the association of the apnea hypopnea index (AHI4%) and platelet aggregation in 482 participants dually enrolled within the Sleep Heart and Health (SHHS) and Framingham Heart Study (FHS) Offspring cohorts. Our primary outcome was the platelet aggregation response to adenosine diphosphate (ADP) 1.0 µmol/L measured by light transmission aggregometry. Other stimulation doses and OSA-related measures were used as secondary for further validation. The relationship between the AHI and platelet aggregation was assessed using standard regression models adjusted for age, sex, years of education, BMI, smoking status, hypertension, diabetes, present CVD history, aspirin use, high-density lipoprotein (HDL) cholesterol, total cholesterol, and triglycerides. We also examined the influence of OSA and CVD-related factors such as age, sex, BMI, hypertension, OSA diagnosis (AHI4% ≥ 5), and the use of platelet modifying drugs. Results No associations were observed between the AHI and platelet aggregation. No associations were observed when stratifying by age (< vs. ≥ 65.0), median BMI (< vs. ≥ 27.85), hypertension (51.9%), or OSA diagnosis (47.1%). AHI was associated with platelet aggregation when stratifying by aspirin use (β= 0.523; p < 0.001; n=65). Associations were found in the same group of aspirin users for secondary exposures: hypoxic burden (β= 0.358; p < 0.001), minimum saturation (β= -0.519; p = 0.026), and the ODI3% (β= 74.672; p = 0.002). Conclusion Our study indicates that the AHI is not associated with platelet aggregation in the general population. Our finding that the AHI is strongly associated with platelet aggregation in participants who are on aspirin for primary prevention of CVD reinforces the need for further examining the mediator role of platelet activity in the association of OSA and CVD risk. Support (if any)
Source: SLEEP
Institutions: New York University, Icahn School of Medicine at Mount Sinai
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4378652392