Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis

Background. Obstructive sleep apnea (OSA) is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickn...

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Main Authors: Rashid Nadeem, Michael Harvey, Mukesh Singh, Ahmed Abdullah Khan, Mustafa Albustani, Aaron Baessler, Essam M. Madbouly, Hassan Sajid, Mahnoor Khan, Nayab Navid
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:International Journal of Vascular Medicine
Online Access:http://dx.doi.org/10.1155/2013/839582
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author Rashid Nadeem
Michael Harvey
Mukesh Singh
Ahmed Abdullah Khan
Mustafa Albustani
Aaron Baessler
Essam M. Madbouly
Hassan Sajid
Mahnoor Khan
Nayab Navid
author_facet Rashid Nadeem
Michael Harvey
Mukesh Singh
Ahmed Abdullah Khan
Mustafa Albustani
Aaron Baessler
Essam M. Madbouly
Hassan Sajid
Mahnoor Khan
Nayab Navid
author_sort Rashid Nadeem
collection DOAJ
description Background. Obstructive sleep apnea (OSA) is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickness (CIMT). Methods. PubMed and Cochrane library were reviewed by utilizing different combinations of key words: sleep apnea, carotid disease, intima media thickness, and carotid atherosclerosis. Inclusion criteria were English articles; studies with adult population with OSA and without OSA; CIMT recorded by ultrasound in mean and standard deviation or median with 95% confidence interval; and OSA defined as apnea hypopnea index of ≥5/h. A total of 95 studies were reviewed for inclusion, with 16 studies being pooled for analysis. Results. Ninety-five studies were reviewed, while 16 studies were pooled for analysis; since some studies have more than one data set, there were 25 data sets with 1415 patients being pooled for meta-analysis. All studies used ultrasound to measure CIMT. CIMT standardized difference in means ranged from −0.883 to 8.01. The pooled standardized difference in means was 1.40 (lower limit 0.996 to upper limit 1.803, (P<0.0001). Conclusion. Patients with OSA appear to have increased CIMT suggestive of an atherosclerotic process.
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spelling doaj-art-ed65e1da8d7c4bafa8f64c9aeeed12132025-08-20T03:21:11ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322013-01-01201310.1155/2013/839582839582Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-AnalysisRashid Nadeem0Michael Harvey1Mukesh Singh2Ahmed Abdullah Khan3Mustafa Albustani4Aaron Baessler5Essam M. Madbouly6Hassan Sajid7Mahnoor Khan8Nayab Navid9Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USAChicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USAChicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USASindh Medical College, Rafiqi H. J. Road, Karachi 75510, PakistanAl-Kindy College of Medicine, University of Baghdad, P.O. Box 47188, Baghdad, IraqChicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USAPulmonary and Sleep Medicine, James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL 60064, USAMcMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, CanadaBenedictine University, 5700 College Road, Lisle, IL 60532, USAChicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USABackground. Obstructive sleep apnea (OSA) is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickness (CIMT). Methods. PubMed and Cochrane library were reviewed by utilizing different combinations of key words: sleep apnea, carotid disease, intima media thickness, and carotid atherosclerosis. Inclusion criteria were English articles; studies with adult population with OSA and without OSA; CIMT recorded by ultrasound in mean and standard deviation or median with 95% confidence interval; and OSA defined as apnea hypopnea index of ≥5/h. A total of 95 studies were reviewed for inclusion, with 16 studies being pooled for analysis. Results. Ninety-five studies were reviewed, while 16 studies were pooled for analysis; since some studies have more than one data set, there were 25 data sets with 1415 patients being pooled for meta-analysis. All studies used ultrasound to measure CIMT. CIMT standardized difference in means ranged from −0.883 to 8.01. The pooled standardized difference in means was 1.40 (lower limit 0.996 to upper limit 1.803, (P<0.0001). Conclusion. Patients with OSA appear to have increased CIMT suggestive of an atherosclerotic process.http://dx.doi.org/10.1155/2013/839582
spellingShingle Rashid Nadeem
Michael Harvey
Mukesh Singh
Ahmed Abdullah Khan
Mustafa Albustani
Aaron Baessler
Essam M. Madbouly
Hassan Sajid
Mahnoor Khan
Nayab Navid
Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
International Journal of Vascular Medicine
title Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
title_full Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
title_fullStr Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
title_full_unstemmed Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
title_short Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
title_sort patients with obstructive sleep apnea display increased carotid intima media a meta analysis
url http://dx.doi.org/10.1155/2013/839582
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