Friday, December 03, 2010


The Radiological Society of North America ( RSNA ), is meeting in Chicago currently. One of the interesting paper presented was a paper on sleep apnea and the heart. Dr Joseph Schoepf and his team from Medical University of South Carolina, studied 95 patients, 49 with obstructive sleep apnea, and 46 without. They were matched for age and BMI. Using CT angiogram, as a means of diagnosing CAD, they found that patients with OSA had more extensive disease and also less calcification in their CAD.
What the authors are saying is that OSA may be associated with atherosclerotic plaques which has a higher lipid core and lesser calcium. An interesting thought. I suppose the weak part of this study, must be the small sample size and the use of CT angio as a means of diagnosis of CAD. True, they are using the later version of dual core technology for their CT angio, but I must say that this method of evaluation of CAD, tend to over-estimate. They tell me that the newer machines are much better, but I am not yet convinced. Yes, the newer machines have less radiation.
The issue is the increasing incidence of obesity in USA, Malaysia and world-wide. What the authors are saying is that obesity is associated with OSA, and CAD. It maybe that OSA is an important reason why obese patients with OSA have high CVS mortality? What is equally important is that a reduction in BMI is associated with a reduction in OSA and CAD.
The exhortation must be for us to reduce our weight, reduce obesity in the community, to help curb CAD.
US statistics have shown us that in the 90s we were able to gradually reduce the incidence of CAD and CVS mortality and morbidity, from our many prevention strategies, statins and revascularisation. In the new millenium we are seeing a rise in obesity, and we are very worried that this will negate all the CVS mortality and morbidity that we have achieved in the 90s.
Nice small study with an important message.

No comments: