Patients with symptoms and characteristics consistent with obstructive sleep apnea are at a higher risk for acute and subacute stent thrombosis after percutaneous coronary stent implantation: a single-center case-control study

Background: To determine if obstructive sleep apnea (OSA) is a risk factor for early stent thrombosis (EST; within 30 days) after percutaneous coronary intervention (PCI). Methods: This case-control study involved 23 patients with angiographically confirmed EST after PCI (case group) and 92 PCI patients (control group) who did not develop stent thrombosis during a 2-year follow-up. Patients with symptoms and characteristics consistent with OSA (hereinafter referred to as OSA) were identified using the Berlin questionnaire, and the general characteristics of the patients and their treatments as well as outcomes were recorded. The odds ratios (ORs) for OSA were calculated. Additionally, the association between OSA and EST in patients with different conventional cardiovascular risk factors was analyzed. Results: The crude OR for OSA was 4.17 (95% confidence interval [CI]: 1.60-10.84, P = 0.003). After adjusting for other risk factors of EST, the OR for OSA remained significant. In participants with no or one conventional cardiovascular disease risk factor, we found a significant association between OSA and EST (OR: 17.00, 95% CI: 2.33-124.19, P = 0.005). Conclusion: OSA is an independent risk factor for EST. This conclusion was further supported by the finding that in patients with few conventional cardiovascular risk factors, the contribution of OSA to EST was more obvious.