P1249Obstructive sleep apnea is associated with lower mortality and lower risk of cardiac complications from myocardial infarction: a nationwide analysis using the national inpatient database of 2014

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Background: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases (CVD). Yet, outcomes of CVD in patients with OSA are unclear. Some studies have indicated that patients with OSA have less severe cardiac injury with non-fatal myocardial infarction (MI), which has been attributed to cardioprotective role of intermittent episodes of hypoxia via ischemic preconditioning. The association between the diagnosis of OSA and mortality from myocardial infarction has not been studied in a large cohort of patients. Methods: In a retrospective cohort study, using the 2014 Nationwide Inpatient Sample (NIS), we analyzed adult patients with MI, who had diagnosis of OSA. The goal of our study was to determine if diagnosis of OSA affects primary and secondary outcomes of MI. We adjusted our results for potential confounders including age, sex, race, hospital location, hospital teaching status, insurance type, hospital bed size and the Charlson Comorbidity Index. Results: We identified 608795 patients with diagnosis of MI, who were further divided into subpopulations with and without OSA. In the OSA group (n=38755) less patients were female (27%) than in non-OSA group (39%) and patients were younger (mean age of 64 and 67 years respectively). OSA was associated with lower mortality (OR=0.66, 95% CI=0.58–0.75) and lower risk of cardiac arrest (OR= 0.79, 95% CI=0.70–0.90). It was also associated with shorter length of stay (Coef.=0.33, 95% CI= 0.21–0.46) as well as lower total charges from length of stay (Coef.=-2252.26, 95% CI= -4248.34- -256.19). As expected, patients with OSA were more likely to use Bilevel Positive Pressure ventilation (OR=3.2, CI=2.86–3.59). OSA was not associated with risk of shock, mechanical ventilation and dialysis due to AKI.

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