ArticleSleep medicine2023
Obesity paradox or hypoxia preconditioning: How obstructive sleep apnea modifies the Obesity-MI relationship.
Article in Sleep medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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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.
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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
8 citing papers in PubMed, 11 citations in OpenAlex.
- TGF‑β1 in obstructive sleep apnea: linking intermittent hypoxia, upper‑airway remodeling, and systemic comorbidities.Sleep & breathing = Schlaf & Atmung · 2026Review
- Expert annotation of free-text descriptions of dream enactment behaviours associated with REM sleep behaviour disorder.Sleep medicine · 2026Article
- Body Roundness Index Versus Body Mass Index: Differential Associations With Obstructive Sleep Apnea Syndrome and All-Cause Mortality in US Adults Aged 20 Years and Older.Brain and behavior · 2025Article
- The Association between All-Cause Mortality and Obstructive Sleep Apnea in Adults: A U-Shaped Curve.Annals of the American Thoracic Society · 2025Article
- The long-term impact of hypertriglyceridemia-waist phenotype on major adverse cardiovascular events in elderly patients with OSA.Sleep & breathing = Schlaf & Atmung · 2025Article
- Lower early mortality and risk prediction improvement of obesity after acute pulmonary embolism: results from a multicenter cohort analysis with external validation.Research and practice in thrombosis and haemostasis · 2025Article
- Validation of electronic diagnostic codes for rapid eye movement sleep behavior disorder.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Major Adverse Cardiac and Cerebrovascular Events in Geriatric Patients with Obstructive Sleep Apnea: An Inpatient Sample Analysis.Medical sciences (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesThe objective of this study was to evaluate the interaction between obesity and obstructive sleep apnea on acute MI in hospital mortality.
methodsThis retrospective cohort study utilized Veterans Health Administration data from years 1999-2020. Participants were categorized according to their body mass index (BMI) to non-obese (BMI <30) and obese (BMI ≥30) groups. Clinical obstructive sleep apnea (SA) diagnosis was confirmed using ICD9/10 codes and the study subgroups included non-obese with no obstructive sleep apnea (nOB-nSA), non-Obese with obstructive sleep apnea (nOB-SA), obese with no obstructive sleep apnea (OB-nSA), and obese with obstructive sleep apnea (OB-SA). The primary outcome was odds ratio of in-hospital mortality during the hospitalization with acute MI as the principal diagnosis adjusted for age, gender, race, ethnicity, and Charlson comorbidity index (CCI) with the nOB-nSA group as the comparison group.
resultsAmong 72,036 veterans with acute-MI hospitalization, individuals with obesity and obstructive sleep apnea (OB-SA) had the lowest in-hospital mortality rate (1.0%) compared to those without obesity and obstructive sleep apnea (nOB-nSA, 2.8%), with obesity but without obstructive sleep apnea (OB-nSA, 2.4%), and with obesity and obstructive sleep apnea (nOB-SA, 1.4%). The adjusted odds ratio for mortality, compared to nOB-nSA, was 9% higher but not significant in OB-nSA (aOR, 1.09, 95%CI: 0.95, 1.25), 46% lower in OB-nSA (aOR, 0.54, 95%CI: 0.45, 0.66), and 52% lower in OB-SA (aOR, 0.48: 95%CI: 0.41, 0.57).
conclusionOur data suggest that the association between obesity and improved survival in acute MI is largely driven by the presence of sleep apnea.
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