TY - JOUR
T1 - A QTc risk score in patients with obstructive sleep apnea
AU - Patel, Salma I.
AU - Zareba, Wojciech
AU - Wendel, Christopher
AU - Perez, Karolina
AU - Patel, Imran
AU - Quan, Stuart F
AU - Youngstedt, Shawn D.
AU - Parthasarathy, Sairam
AU - Woosley, Raymond L.
N1 - Funding Information:
During the writing of this manuscript, Dr. S. Patel was supported by grants from the American Academy of Sleep Medicine Foundation ( AASMF; 203-JF-18 ), National Institutes of Health ( HL126140 ), a University of Arizona Health Sciences. Dr. I. Patel was supported by National Institutes of Health (HL126140). Dr. Parthasarathy was supported by National Institutes of Health ( R25-HL126140 , R33-HL151254 ; OT2-HL161847 ; R21-HD109777 ; C06-OD028307 ; HL140144 ; HL138377 ; OT2-HL156912 and OT2HL158287 ); PCORI ( DI-2018C2-13161 , CER-2018C2-13262 ); Department of Defense ( W81XWH20C0051 and W81XWH2110025 ); Pima County Health Department ( CPIMP211275 ); Arizona Commerce Authority ( LTR DTD 021822 ); Sergey Brin Foundation ; Philips, Inc. ( 0483-06-161311-73077 ); and American Academy of Sleep Medicine Foundation (AASMF; 169-SR-17 ). Dr. Woosley was supported by grants from the Agency for Healthcare Research and Quality ( 1R18HS02666621 ) and the Flinn Foundation . Dr. Quan was supported by HL151637 and HL53938 .
Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/3
Y1 - 2023/3
N2 - Introduction: Patients with obstructive sleep apnea (OSA) are at risk for QTc prolongation, a known risk factor for increased mortality. The pro-QTc score can help identify individuals at increased risk for mortality associated with increased QTc however, it has not been evaluated in patients with OSA. The goal of this study was to evaluate the pro-QTc score in patients with OSA. Methods: Medical records of patients undergoing a sleep study at our sleep center from February 2012 to August 2020 were analyzed. Presence or absence of OSA was determined by polysomnography. The pro-QTc score was calculated with 1 point assigned for each of the following: female sex, QT-prolonging diagnoses and conditions, QT-prolonging electrolyte abnormalities, and medications with known risk for QT-prolongation. Mortality was determined from the electronic medical record of an integrated healthcare system. Results: There were 2246 patients (age 58 ± 15 years, 54% male, 82 dead) with OSA and 421 patients (age 54 ± 18 years, 43% male, 18 dead) without OSA. Of those with OSA, 1628 (72.5%) had at least one risk factor for QTc prolongation. A higher pro-QTc score was associated with greater mortality in patients with OSA (HR 1.48 per pro-QTc score, p < 0.001, 95% CI 1.3–1.7) but not in patients without OSA (HR 1.25 per pro-QTc score, p = 0.30, 95% CI 0.82–1.9), after adjusting for age, body mass index (BMI), and smoking status. Conclusion: In patients with OSA, a higher pro-QTc score was associated with greater mortality.
AB - Introduction: Patients with obstructive sleep apnea (OSA) are at risk for QTc prolongation, a known risk factor for increased mortality. The pro-QTc score can help identify individuals at increased risk for mortality associated with increased QTc however, it has not been evaluated in patients with OSA. The goal of this study was to evaluate the pro-QTc score in patients with OSA. Methods: Medical records of patients undergoing a sleep study at our sleep center from February 2012 to August 2020 were analyzed. Presence or absence of OSA was determined by polysomnography. The pro-QTc score was calculated with 1 point assigned for each of the following: female sex, QT-prolonging diagnoses and conditions, QT-prolonging electrolyte abnormalities, and medications with known risk for QT-prolongation. Mortality was determined from the electronic medical record of an integrated healthcare system. Results: There were 2246 patients (age 58 ± 15 years, 54% male, 82 dead) with OSA and 421 patients (age 54 ± 18 years, 43% male, 18 dead) without OSA. Of those with OSA, 1628 (72.5%) had at least one risk factor for QTc prolongation. A higher pro-QTc score was associated with greater mortality in patients with OSA (HR 1.48 per pro-QTc score, p < 0.001, 95% CI 1.3–1.7) but not in patients without OSA (HR 1.25 per pro-QTc score, p = 0.30, 95% CI 0.82–1.9), after adjusting for age, body mass index (BMI), and smoking status. Conclusion: In patients with OSA, a higher pro-QTc score was associated with greater mortality.
KW - Mortality
KW - Obstructive sleep apnea
KW - Pro-QTc score
KW - QTc risk score
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U2 - 10.1016/j.sleep.2023.02.005
DO - 10.1016/j.sleep.2023.02.005
M3 - Article
C2 - 36805915
AN - SCOPUS:85148719881
SN - 1389-9457
VL - 103
SP - 159
EP - 164
JO - Sleep Medicine
JF - Sleep Medicine
ER -