ArticleThorax2015
Objectively measured sleep characteristics and prevalence of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis Sleep study.
Article in Thorax, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.
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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.
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Who cites it
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Prevalence of coronary atherosclerosis in patients with obstructive sleep apnea syndrome: a systematic review and meta-analysis.Sleep & breathing = Schlaf & Atmung · 2026Pooled it
- Association between apnea-hypopnea index and coronary artery calcification: a systematic review and meta-analysis.Annals of medicine · 2021Pooled it
- Obstructive sleep apnea increases the risk of cardiovascular damage: a systematic review and meta-analysis of imaging studies.Systematic reviews · 2021Pooled it
- Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review.Journal of atherosclerosis and thrombosis · 2017Pooled it
- Association between multiple sleep dimensions in obstructive sleep apnea and an early sign of atherosclerosis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Trial
- Sleep homeostasis impairment across obstructive sleep apnea severity: findings from a population-based cohort study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Increased Vascular Endothelial Growth Factor Receptor 2 Levels Are Associated With a Higher Occurrence of Coronary Artery Disease in Patients With Obstructive Sleep Apnea.Reviews in cardiovascular medicine · 2026Article
- Obstructive Sleep Apnea Risk and Incidental Coronary Artery Calcification on Routine Chest Computed Tomography.Journal of clinical medicine · 2026Article
- Observational
- Association between sleep regularity and arterial stiffness among middle-age adults in Southwestern China.BMC public health · 2024Article
- Actigraphy-based sleep and muscle sympathetic nerve activity in humans.American journal of physiology. Regulatory, integrative and comparative physiology · 2024Article
- Sleep Duration and the Risk of Atherosclerosis: A Mendelian Randomization Study.Arquivos brasileiros de cardiologia · 2024Article
- Sleep Duration, Genetics, and Atherosclerosis: Challenges and Opportunities.Arquivos brasileiros de cardiologia · 2024Article
- Circadian Disruption and the Molecular Clock in Atherosclerosis and Hypertension.The Canadian journal of cardiology · 2023Review
- 40 years of actigraphy in sleep medicine and current state of the art algorithms.NPJ digital medicine · 2023Article
- Sleep apnea and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA): leveraging state-of-the-art vascular imaging.The international journal of cardiovascular imaging · 2023Article
- Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis.Journal of the American Heart Association · 2023Article
- Sensorimotor Cortical Activity during Respiratory Arousals in Obstructive Sleep Apnea.International journal of molecular sciences · 2022Article
- Association between Arousals during Sleep and Subclinical Coronary Atherosclerosis in Patients with Obstructive Sleep Apnea.Brain sciences · 2022Article
- Posttraumatic stress disorder (PTSD), sleep, and cardiovascular disease risk: A mechanism-focused narrative review.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2022Review
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Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundWe tested whether objectively measured indices of obstructive sleep apnoea (OSA) and sleep quality are associated with coronary artery calcification (CAC) prevalence independent of obesity, a classic confounder.
methods1465 Multi-Ethnic Study of Atherosclerosis participants (mean age 68 years), who were free of clinical cardiovascular disease, had both coronary CT and in-home polysomnography and actigraphy performed. OSA categories were defined by the Apnea-Hypopnea Index (AHI). Prevalence ratios (PRs) for CAC >0 and >400 (high burden) were calculated.
resultsParticipants with severe OSA (AHI ≥30; 14.6%) were more likely to have prevalent CAC, relative to those with no evidence of OSA, after adjustment for demographics and smoking status (PR 1.16; 95% CI 1.06 to 1.26), body mass index (1.11; 1.02 to 1.21) and traditional cardiovascular risk factors (1.10; 1.01 to 1.19). Other markers of hypoxaemia tended to be associated with a higher prevalence of CAC >0. For CAC >400, a higher prevalence was observed with both a higher arousal index and less slow-wave sleep. Overall, associations were somewhat stronger among younger participants, but did not vary by sex or race/ethnicity.
conclusionsIn this population-based multi-ethnic sample, severe OSA was associated with subclinical coronary artery disease (CAC >0), independent of obesity and traditional cardiovascular risk factors. Furthermore, the associations of the arousal index and slow-wave sleep with high CAC burden suggest that higher nightly sympathetic nervous system activation is also a risk factor. These findings highlight the potential importance of measuring disturbances in OSA as well as sleep fragmentation as possible risk factors for coronary artery disease.
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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.