Severity of obstructive sleep apnea and its impact on coronary artery disease outcomes: A cross-sectional study in Egypt

Objectives: Coronary artery disease (CAD) and obstructive sleep apnea (OSA) share mechanisms such as intermittent hypoxia, inflammation, and sympathetic activation, worsening cardiac function and CAD severity.This study aimed to assess OSA prevalence in CAD patients and its relationship to CAD severity and cardiac function, while evaluating the diagnostic performance of the STOP-BANG questionnaire.Methods: A cross-sectional observational study was conducted on one hundred CAD patients confirmed by coronary angiography.OSA was diagnosed using the STOP-BANG questionnaire, Epworth Sleepiness Scale (ESS), and polysomnography (apnea-hypopnea index.AHI).CAD severity was measured by the Gensini score.Cardiac function was evaluated by echocardiography, including left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP), tricuspid annular plane systolic excursion (TAPSE) and ratio of early mitral inflow velocity to early diastolic mitr al annular velocity (E/e').Statistical analyses included correlations and ROC curve analysis.Results: OSA was present in 34% of patients, with 24% classified as high-risk (AHI 15).STOP-BANG score >3.5 had 84.2% sensitivity and 77.4% specificity (AUC 0.83, p<0.001) in diagnosing OSA.High-risk OSA patients had lower LVEF (51.3 (7.0) vs. 57.5 (8.0)%, p=0.007), reduced TAPSE (18.4 (1.6) vs. 20.1(1.9)mm, p=0.022), and higher PASP (33.4(2.4)vs.27.9 (7.4) mmHg, p=0.005).Diastolic dysfunction (E/e'=12.4(3.0) vs. 9.2 (2.1), p<0.001) correlated with OSA severity.Gensini scores were higher in OSA patients (60.2 (22.0) vs. 15.9 (8.4), p<0.001) and positively correlated with oxygen desaturation index (ODI).ODI negatively correlated with LVEF and TAPSE.Conclusion: OSA is prevalent in CAD patients and correlates with worsened cardiac function and increased CAD severity.STOP-BANG score is a useful screening tool.Early detection and management may improve outcomes.