Abstract 212: The Association of Sleep Apnea With 1-year Health Status Outcomes in Patients With Peripheral Artery Disease

Background: Comorbid sleep apnea in cardiovascular disease is a predictor of adverse cardiovascular outcomes. It is unknown whether comorbid sleep apnea in PAD is associated with worse PAD-specific health status outcomes.

Methods: PORTRAIT is an international (US, Netherlands, Australia), 16-center, prospective PAD registry. Health status was assessed upon PAD diagnosis and at 12 months (disease-specific Peripheral Artery Questionnaire, PAQ Summary scores). Higher PAQ scores indicate better health status. A sequentially adjusted hierarchical linear regression model examined the association between sleep apnea and 1-year PAQ scores (figure).

Results: Of the 1204 patients with PAD, 8.3% (n=100) had comorbid sleep apnea. The mean age was 67.6 ± 9.4 with 37.5% women. Patients with vs. without sleep apnea were more from the US; more sedentary, presented with more diabetes, obesity, coronary disease and a history of peripheral interventions, but had higher ankle-brachial index values. They also had lower health status scores at presentation and 12 months (41.2 ± 22.0 vs 49.9±21.6 and 58.6±27.9 vs71.3±24.9, respectively, p<0.05). The association between sleep apnea and 1-year health status persisted after adjustment (Figure).

Conclusion: In patients presenting with PAD, comorbid sleep apnea clusters with an overall toxic cardiovascular risk profile. Independent of these risk factors, patients with PAD and sleep apnea obtain less favorable PAD-specific 1-year PAD-specific health status outcomes.

Figure: The Association Between Sleep Apnea and 1-Year PAQ Summary Scores Following Sequential Adjustment for Demographics, Socioeconomic Factors, PAD severity, Psychosocial Factors and Baseline Health Status Score. Estimates represent Beta coefficients and 95% confidence intervals.