Obstructive Sleep Apnea Hypopnea Syndrome as a Reason for Active Management of Pulmonary Embolism
نویسندگان
چکیده
BACKGROUND Obstructive sleep apnea hypopnea syndrome (OSAHS) constitutes an independent factor for high warfarin dose for patients with pulmonary embolism (PE). The aim of this study was to investigate whether the 6-month anticoagulation treatment by warfarin is enough for patients with PE complicated by OSAHS. METHODS We investigated 97 PE patients, 32 of them had OSAHS and 65 non-OSAHS. Warfarin was administered for 6-month if no abnormal circumstances occurred. All patients were followed up for 18 months. Adverse events (AE) included death, major bleeding, hospitalization due to heart failure or pulmonary hypertension, and recurrence or aggravation of PE (including deep vein thrombosis). Recurrence rate of PE after warfarin cessation was compared between the two groups. RESULTS OSAHS patients required a significantly higher dose of warfarin than their non-OSAHS counterparts (4.73 mg vs. 3.61 mg, P < 0.001). During warfarin treatment, no major bleeding and aggravation of PE occurred among OSAHS patients, and the rates of various AE were not significantly different between the OSAHS and non-OSAHS groups. PE recurrence was higher in OSAHS than non-OSAHS groups after withdrawal of warfarin (21.43% vs. 6.78%, P = 0.047). Compared with non-OSAHS patients, OSAHS group had lower international normalized ratio (INR) value but higher plasminogen on baseline and INR resumed to a relatively low level after warfarin discontinuation. CONCLUSIONS OSAHS patients may present with hypercoagulation and relatively high-risk of recurrence of PE after cessation of 6-month warfarin treatment.
منابع مشابه
Determination of The Relationship Between Severity of Obstructive Sleep Apnea And Chronic Obstructive Pulmonary Disease
Introduction: Chronic obstructive pulmonary disease (COPD) patients are at increased risk of sleep-disorders. The concomitant occurrence of COPD and obstructive sleep apnea hypopnea syndrome (OSAHS) is named overlap syndrome. This study aimed to evaluate the severity of OSAHS in overlap syndrome patients.Materials & Methods: This cross-sectional study was conducted on adult patients with forced...
متن کاملThe Evaluation of Diastolic Hypertention in Sleep Overlap Syndrome
Introduction:The overlap syndrome, consisting ofobstructive sleep apnea hypopnea syndrome (OSAHS) and chronic obstructvie pulmonary disease (COPD) is a major problem in COPD patients. OSHAS corresponds to the likelihood of systemic hypertension.The present study was aimed to evaluate the association between apnea-hypopnea index and diastolic blood presssure (DBP) in overlap patients. Materials...
متن کاملObstructive Sleep Apnea Hypopnea Syndrome: An Incognito Player Contributing to Repeated Pulmonary Embolism?
Obstructive sleep apnea hypopnea syndrome as a reason for active management of pulmonary embolism. multiple health risks in a single obstructive sleep apnea population. J Cardiovascular mortality in obstructive sleep apnea in the elderly: Role of long‑term continuous positive airway pressure treatment: A prospective observational study. A, et al. Is obstructive sleep apnea syndrome a risk facto...
متن کاملEffects of Biofeedback Therapy on Cardiovascular and Respiratory Indices in NREM Sleep Parasomnias with Obstructive Sleep Apnea: A Case study
Introduction: Non-REM parasomnias are a relatively common condition in the general human population. Current treatment plans are usually based on small case series and reports. Considering the effects of sleep disorders on different aspects of human life and the failure of pharmacological treatments in this field, the present study was designed to investigate a case of this sleep disorders with...
متن کامل