• Mi Lu, Fang Fang, Zhenjia Wang, Lei Xu, John E Sanderson, Xiaojun Zhan, Lianping He, Chan Wu, and Yongxiang Wei.
• Department of Otolaryngology Head and Neck Surgery-Sleep Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
• Chest. 2021 Nov 1; 160 (5): 1864-1874.

BackgroundLimited evidence is available regarding the association between OSA and coronary plaque assessed by using quantitative coronary CT angiography.Research QuestionAre there any associations between OSA severity-related indexes and the presence and burden of coronary plaque?Study Design And MethodsCross-sectional data from 692 patients who underwent sleep monitoring and coronary CT angiography were used for this study. Of these patients, 120 (17.3%) underwent polysomnography, and 572 (82.7%) underwent respiratory polygraphy. Multivariable logistic and linear regression analyses were used to investigate the associations of OSA severity-related indexes with the presence, volume, and composition of plaque.ResultsIn multivariable analyses, patients with moderate to severe OSA were more likely to have coronary plaques (P = .037), and plaques were more likely to contain a noncalcified plaque (NCP) component (P = .032) and a low-density NCP (LD NCP) component (P = .030). Furthermore, the apnea-hypopnea index and oxygen desaturation index as continuous variables were both associated with the presence of plaque, NCP, and LD NCP (all, P < .05). Multivariable linear regression models showed that moderate to severe OSA was associated with NCP volume (β = 50.328; P = .042) and LD NCP volume (β = 15.707; P = .011). Moreover, the apnea-hypopnea index (P = .015), oxygen desaturation index (P = .005), and percentage of nighttime with oxygen saturation < 90% (P = .017) were all significant predictors of LD NCP volume. Compared with those with no or mild OSA, patients with severe OSA had a significantly higher total plaque volume (P = .036), NCP volume (P = .036), and LD NCP volume (P = .013).InterpretationOSA was independently associated with the presence and burden of coronary plaque, which suggests an increased risk of coronary events.Clinical Trial RegistrationChinese Clinical Trial Registry; No. ChiCTR-ROC-17011027; http://chictr.org.cn.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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