Dados do Trabalho

Título

Aneurysm prognosis in patients with Obstructive Sleep Apnea – Systematic Review

Introdução

Obstructive Sleep Apnea (OSA) consists of recurrent episodes involving partial or total obstruction of the upper airways during sleep. This respiratory disorder has been associated with the development of several chronic diseases, such as systemic and pulmonary arterial hypertension, coronary artery disease, stroke, and type 2 diabetes mellitus. Furthermore, due to the systemic repercussions of OSA, especially on cardiovascular health, studies suggest that OSA may contribute to the occurrence and/or worse prognosis of aneurysms. However, the association between OSA and aneurysms is still controversial.

Objetivo

To evaluate aneurysm prognosis in patients with obstructive sleep apnea.

Métodos

This systematic review meets the PRISMA 2020 protocol. The inclusion criteria were: studies evaluating OSA in patients with aneurysms. The exclusion criteria were: congress abstracts; patients with genetic diseases predisposing to aneurysm formation; or patients with acute aortic syndrome.

Resultados

A total of 510 articles were selected, of which 9 were selected to form the systematic review. The main results were: [1] Jung et al., 2023, evaluated 564 patients who underwent polysomnography and cerebral magnetic resonance angiography. The prevalence of intracranial aneurysms was observed in 59 patients (10.46%) and OSA (AHI ≥ 5) in 412 participants (73%). Intracranial aneurysms were more frequent (12.1% vs. 5.9%; p=0.031) in individuals with OSA compared to the others. [2] In the study by Bir et al., 2017, 283 patients with intracerebral aneurysms underwent polysomnography. Of these, 45 (16%) had a positive diagnosis for OSA and 238 (84%) were negative. The prevalence of ruptured aneurysms in patients with OSA was higher than in those without (60.0% vs. 46.6%, p=0.03) and the risk of vasospasm in aneurysms was higher in OSA compared to controls (30% vs. 18%, p=0.03). [3] Saruhara et al.,2012, conducted a sleep study involving 97 patients using a portable respiratory monitor. Participants with abdominal and thoracic aortic aneurysms had an AHI of 17.8 ± 12.1 (P<0.05) and 16.3 ± 12.1, respectively, while the control group had an AHI of 8.8 ± 5.5.

Conclusões

A higher prevalence of OSA was found in patients with aneurysms when compared to controls. In addition, OSA is associated with a worse prognosis in patients presenting with aneurysms. However, further studies are essential for more robust conclusions.

Palavras -chave

obstructive sleep apnea; aneurysm; prognosis