Links between pulmonary embolism and obstructive sleep apnea: prospective observational cross–sectional study

Background
After myocardial infarction and stroke, pulmonary embolism (PE) ranks highest among vascular causes of mortality. The link between cardiovascular disease and obstructive sleep apnea (OSA) is being more acknowledged. This work aimed to define and evaluate the links between PE and OSA.


Patients and methods
This prospective observational cross–sectional study was conducted on 40 individuals aged greater than 18, both sexes, with PE and OSA. Two equal groups of cases were formed: Those in group I have PE, while those in group II have OSA.


Results
In the PE group, OSA was mild in five (25%) individuals, moderate in three (15%) individuals, and severe in seven (35%) individuals. Weight, BMI, triglyceride, cholesterol, lactate dehydrogenase, STOP-BANG score, apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxygen desaturation index (ODI) were significantly higher in OSA than non-OSA group. Minimal oxygen saturation (SpO2) was significantly lower in the OSA than non-OSA group. In the OSA group, four (20%) patients had PE. D-dimer revised Geneva score, AHI, RDI, ODI, and maximum heart rate were significantly higher in the PE than in the non-PE group.


Conclusions
In the PE group, OSA was mild in 25% of individuals, moderate in 15%, and severe in 35%. OSA had higher BMI, triglycerides, cholesterol, lactate dehydrogenase, STOP-BANG score, AHI, RDI, and ODI, and lower oxygen saturation than PE patients without OSA. In the OSA group, 20% of the cases had PE. PE had higher D-dimer, revised Geneva score, AHI, RDI, ODI, and heart rate than the non-PE group.