Obstructive sleep apnea (OSA) might influence disease severity in acute pulmonary embolism (PE). 253 survivors of acute PE were evaluated for sleep-disordered breathing by portable monitoring and nocturnal polysomnography. PE patients with an apnea-hypopnoea index (AHI) ≥ 15/h were significantly older (p < 0.001), had significantly impaired renal (p < 0.001) and left ventricular functions (p = 0.003), showed significantly elevated troponin I (p = 0.005) and D-dimer levels (p = 0.024), were hospitalised significantly longer (p < 0.001), and had significantly elevated PE severity scores (p = 0.015). Moderate or severe OSA was significantly (p = 0.006) more frequent among intermediate- and high-risk PE patients (81.0%) compared to the low-risk PE cohort (16.3%). Multiple logistic regression analysis revealed that PE patients in the AHI ≥ 15/h cohort were at significant risk for myocardial injury (p = 0.015). Based on clinical risk stratification models, patients with no relevant OSA syndrome tended to be at a lower risk for short-term mortality (p = 0.068). Acute PE might present more severely in OSA patients, possibly due to nocturnal hypoxemia or OSA-related hypercoagulability.
Keywords: Acute pulmonary embolism; Disease severity; Hypercoagulability; Obstructive sleep apnea.