C-Reactive Protein as a Predictor of Cardiovascular Events and Mortality in Obstructive Sleep Apnea: A Propensity-Matched Analysis Using the TriNetX Research Network.

Introduction: Obstructive sleep apnea (OSA) increases cardiovascular disease risk through systemic inflammation, particularly through elevated C-reactive protein (CRP). This study investigated whether CRP stratification predicts mortality and cardiovascular events in OSA patients. Methods: We conducted a retrospective cohort analysis using the TriNetX Research Network, encompassing electronic health records from 130 healthcare institutions. Adults (ages 18-90 years) with OSA were stratified by CRP concentration: elevated (≥ 3.0 mg/L) versus low (≤ 2.9 mg/L). After propensity score matching for demographics and comorbidities, 240,727 participants per cohort were followed for five years. Primary outcome was all-cause mortality; secondary outcomes included cardiovascular events, arrhythmias, and acute kidney injury. Results: Elevated CRP was associated with significantly higher all-cause mortality (11.3% versus 7.0%; HR 1.695, 95% CI 1.662-1.727; Conclusion: Elevated CRP constitutes a robust predictor of mortality and cardiovascular morbidity in OSA populations. Assessment of inflammatory biomarkers may enhance risk stratification, informing intensified monitoring and targeted therapeutic interventions.