Evidence map›Paper›PMID 26038534›Full record

ArticleThorax2015

Association of incident obstructive sleep apnoea with outcomes in a large cohort of US veterans.

Miklos Z Molnar, Istvan Mucsi, Marta Novak, Zoltan Szabo, Amado X Freire, Kim M Huch, Onyebuchi A Arah, Jennie Z Ma, Jun L Lu, John J Sim and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thorax, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 9 pooled it
11.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 9 syntheses or guidelines pooled it, 150 citations in OpenAlex.

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  10. Article
  11. Obstructive sleep apnoea is associated with accelerated progression of diabetic kidney disease.Diabetic medicine : a journal of the British Diabetic Association · 2026
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 4 countries.

Miklos Z MolnarDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Istvan MucsiDepartment of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
Marta NovakInstitute of Behavioral Sciences, Semmelweis University, Budapest, Hungary Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada.
Zoltan SzaboDepartment of Cardiothoracic Surgery and Cardiothoracic Anesthesia, Linköping University Hospital, Linköping, Sweden Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Amado X FreirePulmonary Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA.
Kim M HuchNephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA.
Onyebuchi A ArahDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
Jennie Z MaDivision of Nephrology, University of Virginia, Charlottesville, Virginia, USA.
Jun L LuDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
John J SimKaiser Permanente, Los Angeles, California, USA.
Elani StrejaDivision of Nephrology, University of California, Irvine, California, USA.
Kamyar Kalantar-ZadehDivision of Nephrology, University of California, Irvine, California, USA.
Csaba P KovesdyDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA.
Memphis VA Medical Center · USUniversity of California, Irvine · USUniversity of Tennessee Health Science Center · USKaiser Permanente · USLinköping University Hospital · SESemmelweis University · HUUniversity Health Network · CAUniversity of California, Los Angeles · USUniversity of Virginia · US

Funding

Racial and Cardiovascular Risk Factor Anomalies in CKDR01DK096920 · NIDDK · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI KALANTAR-ZADEH, KAMYAR, KOVESDY, CSABA PAL · 2013 to 2015
$909k
HSRD VA SDR 02-237NIDDK NIH HHS 1R01DK096920NIDDK NIH HHS R01 DK096920
6 · The paper itself

Abstract

rationaleThere is a paucity of large cohort studies examining the association of obstructive sleep apnoea (OSA) with clinical outcomes including all-cause mortality, coronary heart disease (CHD), strokes and chronic kidney disease (CKD).

objectivesWe hypothesised that a diagnosis of incident OSA is associated with higher risks of these adverse clinical outcomes. METHODS, MEASUREMENTS: In a nationally representative cohort of over 3 million (n=3 079 514) US veterans (93% male) with baseline estimated glomerular filtration rate (eGFR)≥60 mL/min/1.73 m(2), we examined the association between the diagnosis of incident OSA, treated and untreated with CPAP, and: (1) all-cause mortality, (2) incident CHD, (3) incident strokes, (4)incident CKD defined as eGFR<60 mL/min/1.73 m(2), and (5) slopes of eGFR. MAIN

resultsCompared with OSA-negative patients, untreated and treated OSA was associated with 86% higher mortality risk, (adjusted HR and 95% CI 1.86 (1.81 to 1.91) and 35% (1.35 (1.21 to 1.51)), respectively. Similarly, untreated and treated OSA was associated with 3.5 times (3.54 (3.40 to 3.69)) and 3 times (3.06 (2.62 to 3.56)) higher risk of incident CHD; 3.5 times higher risk of incident strokes (3.48 (3.28 to 3.64) and 3.50 (2.92 to 4.19)) for untreated and treated OSA, respectively. The risk of incident CKD was also significantly higher in untreated (2.27 (2.19 to 2.36)) and treated (2.79 (2.48 to 3.13)) patients with OSA. The median (IQR) of the eGFR slope was -0.41 (-2.01 to 0.99), -0.61 (-2.69 to 0.93) and -0.87 (-3.00 to 0.70) mL/min/1.73 m(2) in OSA-negative patients, untreated OSA-positive patients and treated OSA-positive patients, respectively.

conclusionsIn this large and contemporary cohort of more than 3 million US veterans, a diagnosis of incident OSA was associated with higher mortality, incident CHD, stroke and CKD and with faster kidney function decline.

Indexed as

AgedCohort StudiesCoronary DiseaseFemaleHumansIncidenceMaleMiddle AgedRenal Insufficiency, ChronicRisk FactorsSleep Apnea, ObstructiveStrokeSurvival AnalysisUnited StatesVeterans

Identifiers

PMID26038534
PMCPMC4575815
OpenAlexW2138716526

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.