• Adeline Tan, William Hau, Hee-Hwa Ho, Haleh Ghaem Maralani, Germaine Loo, See-Meng Khoo, Bee-Choo Tai, A Mark Richards, Paul Ong, and Chi-Hang Lee.
• Chest. 2014 Feb 1;145(2):322-30.

BackgroundVirtual histology intravascular ultrasound (VH-IVUS) is an intravascular imaging technique that enables the characterization of coronary plaques. We sought to determine the association between OSA and coronary plaque characteristics in patients presenting with coronary artery disease.MethodsWe prospectively recruited patients with angiographically proven coronary artery disease for a VH-IVUS examination and home-based sleep study. The total atheroma volume of the entire target coronary artery and the incidence of thin cap fibroatheroma of patients with no to mild and moderate to severe OSA were compared.ResultsOne hundred eighteen patients were recruited from two university-affiliated centers. Among the 93 patients who completed the study, 32 (34.4%) had newly diagnosed moderate to severe OSA (apnea-hypopnea index > 15). Compared with patients with no to mild OSA, those with moderate to severe OSA had a larger total atheroma volume (461.3 ± 250.4 mm³ vs 299.2 ± 135.6 mm³, P < .001), and the association remained after adjustment for age, BMI, hypertension, diabetes mellitus, smoking, and hyperlipidemia (relative mean difference, 1.73; 95% CI, 1.38-2.15). In contrast, there were no significant differences between the patients with moderate to severe OSA and no to mild OSA regarding the prevalence of thin cap fibroatheroma in the culprit lesion (53.1% vs 54.2%, P = .919).ConclusionsIn patients presenting with coronary artery disease, moderate to severe OSA was independently associated with a larger total atheroma volume in the target coronary artery. Further studies on the effects of CPAP on total atheroma volume are warranted.Trial RegistryClinicalTrials.gov; No.: NCT01306526; URL: www.clinicaltrials.gov.

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