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Respir Med. 2014 Jul;108(7):1060-3. doi: 10.1016/j.rmed.2014.04.005. Epub 2014 Apr 23.

Effect of CPAP treatment on plasma high sensitivity troponin levels in patients with obstructive sleep apnea.

Author information

1
Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: antonia.barcelo@ssib.es.
2
Servei de Pneumologia, Hospital Arnau de Vilanova, IRB Lleida, Spain.
3
Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain.
4
Unitat d'Investigació, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
5
Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
6
Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
7
Servei de Pneumologia, Hospital Arnau de Vilanova, IRB Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.

Abstract

BACKGROUND:

Obstructive sleep apnea (OSA) is associated with an increased prevalence of cardiovascular diseases. New generations of highly sensitive assays for cardiac troponin (hs-cTnT) have been introduced recently, and a number of clinical observations have challenged the notion that troponins are only increased in blood following irreversible necrosis.

OBJECTIVE:

The aims of this study were to compare the levels of hs-cTnT between a group of healthy controls and a group of patients with OSA without co-existent coronary artery disease, and to assess the possible influence of the treatment with Continuous positive airway pressure (CPAP) on these levels.

METHODS:

The study population included 200 male participants. The case (n = 133) or control (n = 67) status was defined by an apnea-hypopnea index of 10 or greater. The hs-cTnT assay was validated as reported previously, with a limit of detection of 3 ng/L and an upper reference limit (99th percentile) of 14 ng/L.

RESULTS:

The proportion of subjects with detectable plasma hs-cTnT was higher in patients with OSA than in controls (61 vs 75%, p = 0.04). In patients, a significant increase in hs-cTnT levels was observed after an effective treatment with CPAP (7.3 ± 3.4 vs 10.1 ± 4.9 ng/L; p < 0.01).

CONCLUSION:

This study shows that the percentage of subjects with detectable hs-cTnT is associated with the presence of OSA. It also evidences that treatment with CPAP is followed by a rise in hs-cTnT concentrations. It is reasonable to suggest that CPAP therapy might induce a potential degree of cardiac stress, resulting in deleterious consequences for the heart.

KEYWORDS:

CPAP; Cardiac biomarker; Sleep apnea; Sleep disordered breathing; Troponin; hs-cTnT

PMID:
24797213
DOI:
10.1016/j.rmed.2014.04.005
[Indexed for MEDLINE]
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