Obstructive sleep apnea is associated with increased coronary plaque instability: an optical frequency domain imaging study

• Published in: Heart and vessels Vol. 34; no. 8; pp. 1266 - 1279
• Main Authors: Konishi, Takao, Kashiwagi, Yusuke, Funayama, Naohiro, Yamamoto, Tadashi, Murakami, Hironori, Hotta, Daisuke, Tanaka, Shinya
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.08.2019; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Apnea; Arteriosclerosis; Atherosclerosis; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular disease; Cardiovascular diseases; Cerebral infarction; Coronary artery; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - etiology; Coronary Artery Disease - pathology; Coronary vessels; Female; Frequency domain analysis; Frequency stability; Health risks; Heart diseases; Humans; Lesions; Lipids; Logistic Models; Macrophages; Male; Medical imaging; Medicine; Medicine & Public Health; Microchannels; Middle Aged; Morphology; Myocardial infarction; Optical frequency; Original; Original Article; Percutaneous Coronary Intervention; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - pathology; Plaques; Polysomnography; Retrospective Studies; Sleep; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - pathology; Sleep disorders; Tomography, Optical Coherence; Vascular Surgery; Obstructive sleep apnea; Plaque instability; Optical frequency domain imaging
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-019-01363-8

Obstructive sleep apnea (OSA) is associated with coronary artery disease (CAD) and with an increased risk for myocardial infarction, stroke or death due to cardiovascular disease. Optical frequency-domain imaging (OFDI) is a useful modality for evaluating the characteristics of atherosclerotic plaque. The purpose of the study was to use OFDI to investigate the association of OSA with coronary plaque characteristics in patients undergoing percutaneous coronary intervention (PCI). We retrospectively analyzed OFDI data for coronary artery plaques from 15 patients with OSA and 35 non–OSA patients treated between October 2015 and October 2018. Plaque morphology was evaluated for 70 lesions, including 21 from patients with OSA and 49 from non–OSA patients. Compared with the non–OSA group, patients with OSA had significantly higher prevalences of thinned cap fibroatheroma (TCFA) (67% vs. 35%, P  = 0.014) and microchannels (86% vs. 55%, P  = 0.014); a significantly higher mean lipid index (1392 ± 982 vs. 817 ± 699, P  = 0.021), macrophage grade (8.4 ± 6.4 vs. 4.8 ± 4.5, P  = 0.030), and maximum number of microchannels (1.5 ± 1.0 vs. 0.7 ± 0.7, P  = 0.001); and a significantly lower mean minimum fibrous cap thickness (69.4 ± 28.7 vs. 96.1 ± 51.8 μm, P  = 0.008). This OFDI analysis suggests that OSA is associated with unstable plaque characteristics in patients with CAD. More intensive medical management for stabilization of coronary atherosclerotic plaque is required in patients with OSA.