Obstructive Sleep Apnea Impacts In-Hospital Outcomes After Transcatheter Mitral Valve Repair: Insights From the National Inpatient Sample
Sitammagari K, Kondamareddy D, Dhanireddy BR, Dontaraju V, Desai R, Ninan JK, and Villablanca P. Obstructive Sleep Apnea Impacts In-Hospital Outcomes After Transcatheter Mitral Valve Repair: Insights From the National Inpatient Sample. JACC: Cardiovasc Interv 2020; 13(4):S58.
JACC: Cardiovasc Interv
Background: Obstructive sleep apnea (OSA) is an independent risk factor for many cardiovascular conditions. However, the association of OSA with outcomes in patients undergoing transcatheter mitral valve repair (TMVr) has not been established. Methods: From January 2011 to September 2015, TMVr procedures among adults were identified using the National Inpatient Sample. The determination of OSA versus non-OSA patients was made by ICD-9 codes. Multivariate linear and logistic regressions were used to calculate odds ratios for primary and secondary outcomes while adjusting for confounders. Results: We identified 5,093 patients who underwent TMVr procedure; of which 458 (8.9%) had documented OSA. Patients with OSA were younger, more likely to be male and had a high burden of comorbidities including diabetes, dyslipidemia, previous coronary artery bypass surgery, chronic pulmonary disease, obesity, liver disease, peripheral vascular disorders, renal failure and coagulopathy (p<0.05 for all). There was no significant difference in all-cause in-hospital mortality (aOR 1.18, p=0.675) between the two groups. Patients with OSA had higher odds of in-hospital cardiac arrest (aOR 4.41, p<0.001), cardiogenic shock (aOR 2.59, p<0.001), postoperative myocardial infarction (aOR 6.20, p<0.001), acute kidney injury requiring dialysis (aOR 54.47, p<0.001), and mechanical ventilation (aOR 2.25, p<0.001) as compared to non-OSA patients. Conclusion: In-hospital mortality after TMVr was not influenced by the presence of OSA. However, OSA patients had a significantly higher prevalence of cardiovascular comorbidities and higher in-hospital complications.