Evidence map›Paper›PMID 40056262›Full record

ArticleSleep & breathing = Schlaf & Atmung2025

Association of obstructive sleep apnea with cardiovascular events in acute coronary syndrome patients with dual risk of remnant cholesterol and low-grade inflammation: a post-hoc analysis of the OSA-ACS study.

Ding Xu, Yuekun Zhang, Lei Zhen, Wen Hao, Wen Zheng, Yan Yan, Xiao Wang, Shaoping Nie

Abstract read
PubMed Publisher
In one paragraph

Article in Sleep & breathing = Schlaf & Atmung, 2025. 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. Article
  2. Review
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

8 authors.

Ding Xu *Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Yuekun Zhang *Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Lei ZhenCenter for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Wen HaoCenter for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Wen ZhengCenter for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Yan YanCenter for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Xiao WangCenter for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. spaceeye123@126.com.
Shaoping NieCenter for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. spnie@ccmu.edu.cn.

Funding

Beijing Hospitals Authority Clinical Medicine Development of special funding support ZLRK202318Beijing Municipal Natural Science Foundation Grant JQ24039Beijing Municipal Science & Technology Commission Z221100003522027National Key R&D Program of China 2022YFC2505600
6 · The paper itself

Abstract

purposeObstructive sleep apnea (OSA) is a recognized cardiovascular risk factor, yet the benefits of intervention remain uncertain due to the heterogeneity among OSA patients. We aimed to explore the association of OSA with cardiovascular outcomes in acute coronary syndrome (ACS) patients with dual risk of elevated remnant cholesterol (RC) and low-grade inflammation indicated by high-sensitivity C-reactive protein (hs-CRP).

methodsThis study is a post-hoc analysis of OSA-ACS project enrolled 1833 ACS patients from January 2015 to December 2019, who underwent a sleep study, categorized into four groups by median levels of RC and hs-CRP: RC and low-grade inflammation risk (RCIR), low-grade inflammation risk (LDIR), RC risk (RCR), and no residual risk. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) including cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina or heart failure, and ischemia-driven revascularization. Cox proportional hazards models were used to assess the association between OSA and cardiovascular events.

resultsAfter a median follow-up of 35.13 months, OSA significantly increased the risk of MACCE (adjusted hazard ratio [HR] 1.58, 95% confidence interval [CI] 1.01-2.47; p = 0.045) and stroke (adjusted HR 5.23, 95% CI 1.19-22.99; p = 0.027) in the RCIR group. In the RCIR group, the log-transformed AHI (Log-AHI) and ODI (Log-ODI) were both significantly associated with an increased risk of MACCE, with adjusted hazard ratios of 1.711 (95% CI: 1.092-2.679; p = 0.019) and 1.813 (95% CI: 1.039-3.163; p = 0.036), respectively. Moreover, log-transformed nadir SaO2 (Log-Nadir SaO2) demonstrated a significant inverse association with MACCE risk (adjusted HR: 0.033; 95% CI: 0.001-0.769; p = 0.034).

conclusionsOSA is prevalent and more severe in ACS patients with dual risk of elevated RC and low-grade inflammation, significantly increasing MACCE and stroke risk, highlighting the need for routine screening and comprehensive management to reduce cardiovascular risk.

Indexed as

Acute Coronary SyndromeCardiovascular DiseasesCholesterolInflammationSleep Apnea, ObstructiveAgedC-Reactive ProteinFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedRisk FactorsCholesterolC-Reactive ProteinAcute coronary syndromeHs-CRPLow-grade inflammationObstructive sleep apneaRemnant cholesterol

Identifiers

PMID40056262

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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.