Evidence map›Paper›PMID 36061830›Full record

ArticleThe EPMA journal2022

Sleep apnea predicts cardiovascular death in patients with Marfan syndrome: a cohort study.

Nele Gessler, Peter Wohlmuth, Omar Anwar, Eike Sebastian Debus, Christian Eickholt, Melanie A Gunawardene, Samer Hakmi, Kathrin Heitmann, Meike Rybczynski, Helke Schueler and 6 more

Abstract read
In one paragraph

Article in The EPMA journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Nele GesslerDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.ORCID 0000-0001-5626-7749
Peter WohlmuthAsklepios Proresearch, Research Institute, Hamburg, Germany.
Omar AnwarDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Eike Sebastian DebusDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Berlin, Germany.
Christian EickholtDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Melanie A GunawardeneDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Samer HakmiDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Kathrin HeitmannDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Meike RybczynskiDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Berlin, Germany.
Helke SchuelerDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Berlin, Germany.
Sara SheikhzadehEmergency Department, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Hamburg, Germany.
Eike TiggesDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Gunther H WiestDepartment of Pneumology and Sleep Medicine, Asklepios Clinic Harburg, Semmelweis University, Campus Hamburg, Hamburg, Germany.
Stephan WillemsDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Clinic St. Georg, Semmelweis University, Campus Hamburg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany.
Ekaterina AdamUniversity Heart Center Hamburg Eppendorf, Hamburg, Germany.
Yskert von KodolitschDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Surgical replacement of the aortic root is the only intervention that can prevent aortic dissection and cardiovascular death in Marfan syndrome (MFS). However, in some individuals, MFS also causes sleep apnea. If sleep apnea predicts cardiovascular death, a new target for predictive, preventive, and personalized medicine (PPPM) may emerge for those individuals with MFS who have sleep apnea. Methods: This is an investigator-initiated study with long-term follow-up data of 105 individuals with MFS. All individuals were screened for sleep apnea regardless of symptoms. Cardiovascular death served as a primary endpoint, and aortic events as a secondary outcome. Results: Sleep apnea with an apnea-hypopnea index (AHI) > 5/h was observed in 21.0% (22/105) with mild sleep apnea in 13% (14/105) and moderate to severe sleep apnea in 7.6% (8/105). After a median follow-up of 7.76 years (interquartile range: 6.84, 8.41), 10% (10/105) had died, with cardiovascular cause of death in 80% (8/10). After adjusting for age and body mass index (BMI), the AHI score emerged as an independent risk factor for cardiovascular death (hazard ratio 1.712, 95% confidence interval [1.061-2.761], Interpretation: Sleep apnea is emerging as an independent predictor of cardiovascular death in MFS. It seems mandatory to screen all individuals with MFS for sleep apnea and to include these individuals, with both MFS and sleep apnea, in further studies to evaluate the impact of preventive measures with regard to cardiovascular death. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-022-00291-4.

Indexed as

Aortic ruptureCardiovascular deathConnective tissue deficitsMarfan syndromeMortalityPredictive preventive personalized medicineSleep apnea

Identifiers

PMID36061830
PMCPMC9437159

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Registered trials

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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.