Sleep Apnea and Risk of Deep Vein Thrombosis: A Non-randomized, Pair-matched Cohort Study

被引:52
作者
Chou, Kun-Ta [4 ,5 ]
Huang, Chin-Chou [1 ,6 ,7 ,8 ,9 ]
Chen, Yuh-Min [5 ,7 ]
Su, Kang-Cheng [2 ,5 ,7 ]
Shiao, Guang-Ming [5 ,7 ]
Lee, Yu-Chin [5 ,7 ]
Chan, Wan-Leong [1 ,3 ,4 ,7 ]
Leu, Hsin-Bang [1 ,3 ,4 ,7 ,8 ]
机构
[1] Taipei Vet Gen Hosp, Healthcare & Management Ctr, Taipei 112, Taiwan
[2] Natl Yang Ming Univ, Inst Emergency & Crit Care Med, Taipei 112, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med, Div Cardiol, Taipei 112, Taiwan
[4] Natl Yang Ming Univ, Inst Clin Med, Taipei 112, Taiwan
[5] Taipei Vet Gen Hosp, Dept Chest Med, Taipei 112, Taiwan
[6] Natl Yang Ming Univ, Inst Pharmacol, Taipei 112, Taiwan
[7] Natl Yang Ming Univ, Sch Med, Fac Med, Taipei 112, Taiwan
[8] Natl Yang Ming Univ, Sch Med, Cardiovasc Res Ctr, Taipei 112, Taiwan
[9] Taipei Vet Gen Hosp, Dept Med Res & Educ, Taipei 112, Taiwan
关键词
Deep vein thrombosis; Intermittent hypoxia; Sleep apnea; Sleep-disordered breathing; VENOUS THROMBOEMBOLISM; CARDIOVASCULAR-DISEASE; KAPPA-B; COAGULATION; HYPOXIA; INFLAMMATION; HYPERTENSION; METAANALYSIS; ASSOCIATION; POPULATION;
D O I
10.1016/j.amjmed.2011.07.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Patients with sleep apnea have been reported to be associated with increased prevalence of deep vein thrombosis (DVT) in some papers, which were criticized for either a small sample size or lack of a prospective control. Our study strived to explore the relationship of sleep apnea and the subsequent development of DVT using a nationwide, population-based database. METHODS: From 2000 to 2007, we identified a study cohort consisting of newly diagnosed sleep apnea cases in the National Health Insurance Research Database. A control cohort without sleep apnea, matched for age, sex, comorbidities, major operation, and fractures, was selected for comparison. The 2 cohorts were followed-up, and we observed the occurrence of DVT by registry of DVT diagnosis. RESULTS: Of the 10,185 sampled patients (5680 sleep apnea patients vs. 4505 control), 40 (0.39%) cases developed DVT during a mean follow-up period of 3.56 years, including 30 (0.53%) from the sleep apnea cohort and 10 (0.22 %) from the control group. Subjects with sleep apnea experienced a 3.113-fold (95% confidence interval, 1.516-6.390; P = .002) increase in incident DVT, which was independent of age, sex, and comorbidities. Kaplan-Meier analysis also revealed the tendency of sleep apnea patients toward DVT development (log-rank test, P = .001). The risk of DVT was even higher in sleep apnea cases who needed continuous positive airway pressure treatment (hazard ratio 9.575; 95% confidence interval, 3.181-28.818; P < .001). CONCLUSION: Sleep apnea may be an independent risk factor for DVT. (C) 2012 Elsevier Inc. All rights reserved. The American Journal of Medicine (2012) 125, 374-380
引用
收藏
页码:374 / 380
页数:7
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