Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study

Background/Objectives: Heart failure presents a significant public health challenge, affecting millions in the US, with projections of increasing prevalence and economic burdens. Obstructive sleep apnea (OSA) is highly prevalent among HF patients. This study analyzes the impact of OSA on the outcome...

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Main Authors: Abdulmajeed Alharbi, Nahush Bansal, Anas Alsughayer, Momin Shah, Waleed Alruwaili, Mohammed Mhanna, Halah Alfatlawi, Eun Seo Kwak, Ayman Salih, Mohanad Qwaider, Ragheb Assaly
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Hearts
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Online Access:https://www.mdpi.com/2673-3846/5/4/40
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author Abdulmajeed Alharbi
Nahush Bansal
Anas Alsughayer
Momin Shah
Waleed Alruwaili
Mohammed Mhanna
Halah Alfatlawi
Eun Seo Kwak
Ayman Salih
Mohanad Qwaider
Ragheb Assaly
author_facet Abdulmajeed Alharbi
Nahush Bansal
Anas Alsughayer
Momin Shah
Waleed Alruwaili
Mohammed Mhanna
Halah Alfatlawi
Eun Seo Kwak
Ayman Salih
Mohanad Qwaider
Ragheb Assaly
author_sort Abdulmajeed Alharbi
collection DOAJ
description Background/Objectives: Heart failure presents a significant public health challenge, affecting millions in the US, with projections of increasing prevalence and economic burdens. Obstructive sleep apnea (OSA) is highly prevalent among HF patients. This study analyzes the impact of OSA on the outcomes in patients admitted with acute decompensated heart failure. Methods: We conducted a retrospective cohort study using the National Inpatient Sample database (NIS) 2020, focusing on patients admitted with acute heart failure. Patient outcomes were compared between those with and without a secondary diagnosis of OSA, identified via validated ICD-10 codes. Subgroup analysis was conducted between heart failure patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). Results: Among 65,649 patients with acute heart failure, 4595 (7%) patients were found to have OSA. The patients with OSA were more likely to be male, older in age and had a higher burden of comorbidities. No significant differences were observed in mortality between heart failure patients with and without OSA. In HFrEF patients, OSA was associated with longer hospital stays (6.45 days vs. 5.79 days, <i>p</i> < 0.001), higher rates of acute kidney injury (AKI) (adjusted odds ratio 1.28, 95% CI: 1.07–1.54, <i>p</i> = 0.007), and atrial fibrillation (adjusted odds ratio 1.35, 95% CI: 1.13–1.61, <i>p</i> = 0.001). In HFpEF patients, an association between OSA and AF was observed (adjusted odds ratio 1.20, 95% CI: 1.01–1.42, <i>p</i> = 0.03). Conclusions: OSA is associated with poor in-hospital outcomes in patients admitted with acute heart failure. HFrEF subgroup is especially vulnerable, with OSA leading to a significant increase in healthcare utilization and complication rates in these patients. This nationwide study underscores the importance of timely identification and treatment of OSA in heart failure to alleviate healthcare burdens and improve patient outcomes.
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spelling doaj-art-a01daa63af8a470181ebba3af0b3d2ee2025-08-20T02:00:33ZengMDPI AGHearts2673-38462024-11-015454755610.3390/hearts5040040Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort StudyAbdulmajeed Alharbi0Nahush Bansal1Anas Alsughayer2Momin Shah3Waleed Alruwaili4Mohammed Mhanna5Halah Alfatlawi6Eun Seo Kwak7Ayman Salih8Mohanad Qwaider9Ragheb Assaly10Division of Cardiology, Tufts Medical Center, Boston, MA 02111, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, West Virginia University, Morgantown, WV 26506, USADivision of Cardiology, University of Iowa, Iowa City, IA 52242, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, The University of Toledo, Toledo, OH 43606, USADivision of Pulmonary and Critical Care Medicine, The University of Toledo, Toledo, OH 43606, USABackground/Objectives: Heart failure presents a significant public health challenge, affecting millions in the US, with projections of increasing prevalence and economic burdens. Obstructive sleep apnea (OSA) is highly prevalent among HF patients. This study analyzes the impact of OSA on the outcomes in patients admitted with acute decompensated heart failure. Methods: We conducted a retrospective cohort study using the National Inpatient Sample database (NIS) 2020, focusing on patients admitted with acute heart failure. Patient outcomes were compared between those with and without a secondary diagnosis of OSA, identified via validated ICD-10 codes. Subgroup analysis was conducted between heart failure patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). Results: Among 65,649 patients with acute heart failure, 4595 (7%) patients were found to have OSA. The patients with OSA were more likely to be male, older in age and had a higher burden of comorbidities. No significant differences were observed in mortality between heart failure patients with and without OSA. In HFrEF patients, OSA was associated with longer hospital stays (6.45 days vs. 5.79 days, <i>p</i> < 0.001), higher rates of acute kidney injury (AKI) (adjusted odds ratio 1.28, 95% CI: 1.07–1.54, <i>p</i> = 0.007), and atrial fibrillation (adjusted odds ratio 1.35, 95% CI: 1.13–1.61, <i>p</i> = 0.001). In HFpEF patients, an association between OSA and AF was observed (adjusted odds ratio 1.20, 95% CI: 1.01–1.42, <i>p</i> = 0.03). Conclusions: OSA is associated with poor in-hospital outcomes in patients admitted with acute heart failure. HFrEF subgroup is especially vulnerable, with OSA leading to a significant increase in healthcare utilization and complication rates in these patients. This nationwide study underscores the importance of timely identification and treatment of OSA in heart failure to alleviate healthcare burdens and improve patient outcomes.https://www.mdpi.com/2673-3846/5/4/40heart failureobstructive sleep apneaheart failure with reduced ejection fractionheart failure with preserved ejection fractionOSA
spellingShingle Abdulmajeed Alharbi
Nahush Bansal
Anas Alsughayer
Momin Shah
Waleed Alruwaili
Mohammed Mhanna
Halah Alfatlawi
Eun Seo Kwak
Ayman Salih
Mohanad Qwaider
Ragheb Assaly
Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study
Hearts
heart failure
obstructive sleep apnea
heart failure with reduced ejection fraction
heart failure with preserved ejection fraction
OSA
title Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study
title_full Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study
title_fullStr Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study
title_full_unstemmed Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study
title_short Impact of Obstructive Sleep Apnea in Patients with Acute Heart Failure: A Nationwide Cohort Study
title_sort impact of obstructive sleep apnea in patients with acute heart failure a nationwide cohort study
topic heart failure
obstructive sleep apnea
heart failure with reduced ejection fraction
heart failure with preserved ejection fraction
OSA
url https://www.mdpi.com/2673-3846/5/4/40
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