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July 1, 2026Clinical CardiologyOpen Access

AHI links to ~2% higher odds of HFpEF-like phenotype in CAD only when excluding BMI.

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Why the study?

Is obstructive sleep apnea independently associated with an HFpEF-like phenotype in patients with revascularized coronary artery disease?

Population

435 patients with revascularized coronary artery disease and preserved left ventricular ejection fraction…

Design

Cohort

Key result

Obstructive sleep apnea severity (AHI) was associated with an HFpEF-like phenotype in CAD patients only when excluding BMI from the model (OR 1.019; 95% CI 1.005-1.033).

Authors

ETErik ThunströmHGHelena GlantzAPAylin Pıhtılı

Discussion

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Overview

OSA screening may flag HFpEF risk in CAD; leaves open independent OSA effects and CPAP benefit.

Key Points

  • This research aims to explore the prevalence and clinical correlates of an HFpEF-like phenotype in patients with coronary artery disease and obstructive sleep apnea.
  • Included 435 patients with preserved left ventricular ejection fraction from the RICCADSA cohort.
  • Used multivariable logistic regression to analyze associations with age, sex, obesity, hypertension, diabetes, and OSA status.
  • Evaluated the apnea-hypopnea index as a continuous variable, assessing the impact of obesity.
  • 69.9% of participants met the HFpEF-like criteria.
  • Age and obesity were independently associated with the HFpEF-like phenotype, while categorical OSA was not.
  • AHI and ODI became significant predictors when excluding body mass index with OR 1.019 (95% CI 1.005-1.033) and OR 1.030 (95% CI 1.010-1.050), respectively.

Study Design

Type

Cohort (n=435)

Structured PICO

Is obstructive sleep apnea independently associated with an HFpEF-like phenotype in patients with revascularized coronary artery disease?

P
Population
435 patients with revascularized coronary artery disease and preserved left ventricular ejection fraction evaluated for an HFpEF-like phenotype.
E
Exposure
Obstructive sleep apnea (defined as apnea-hypopnea index [AHI] ≥ 15 events/h) and continuous measures of sleep apnea severity (AHI and oxygen desaturation index [ODI]).
O
Outcome
Prevalence and clinical correlates of an HFpEF-like phenotype (defined by ≥ 2 of the following: E/e' ≥ 15, left atrial enlargement, increased left ventricular mass index, pulmonary artery systolic pressure ≥ 35 mmHg, and NT-proBNP ≥ 125 pg/mL).surrogate

Main Result

Odds Ratio: 1.019 (95% CI 1.005–1.033)

An HFpEF-like phenotype is highly prevalent (69.9%) in patients with revascularized CAD and is primarily driven by aging and obesity, with the impact of OSA severity being dependent on adiposity.

Cite This Study

Thunström et al. (2026) conducted a cohort in Coronary artery disease and obstructive sleep apnea (n=435). Obstructive sleep apnea (OSA) severity (AHI) was evaluated on HFpEF-like phenotype (OR 1.019, 95% CI 1.005-1.033). Obstructive sleep apnea severity (AHI) was associated with an HFpEF-like phenotype in CAD patients only when excluding BMI from the model (OR 1.019; 95% CI 1.005-1.033).

synapsesocial.com/papers/6a44add75cd2549c8bc43386https://doi.org/10.1002/clc.70402
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