阻塞性睡眠呼吸暂停作为视网膜静脉阻塞后系统性血栓栓塞风险的修饰因素
Obstructive Sleep Apnea as a Modifier of Systemic Thromboembolic Risk Following Retinal Vein Occlusion.
文献信息
| PMID | 42765872 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Neil Dogra |
| 作者单位 | University of Rochester School of Medicine and Dentistry, Rochester, NY. |
| 期刊 | Retina (Philadelphia, Pa.) |
| SCI 分区 | Q3 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 视网膜静脉阻塞（RVO）后的系统性血管风险分层仍然有限。我们评估了合并阻塞性睡眠呼吸暂停（OSA）是否会修饰RVO后的血栓栓塞风险。
方法： 使用TriNetX Analytics Network进行的回顾性队列研究。将有或无既往OSA的RVO患者按人口学特征和合并症进行1:1匹配。1年、3年和5年的新发结局包括抗凝启动、复合静脉血栓栓塞（VTE；肺栓塞或深静脉血栓形成）、心肌梗死、复合动脉血栓栓塞（ATE；脑梗死、短暂性脑缺血发作或动脉栓塞）、脑梗死、出血性卒中、颈动脉疾病和死亡的风险比（HR[95%置信区间]）。二次匹配分析比较了OSA患者中中央RVO（CRVO）与分支RVO（BRVO）。
结果： 匹配后，每个队列剩余10,728例患者。OSA与抗凝启动增加（1年：HR 1.38[1.18-1.61]；3年：HR 1.29[1.16-1.44]；5年：HR 1.32[1.19-1.45]）、VTE（1年：HR 1.48[1.20-1.82]；3年：HR 1.46[1.26-1.69]；5年：HR 1.44[1.26-1.63]）和心肌梗死（3年：HR 1.21[1.06-1.38]；5年：HR 1.17[1.04-1.31]）相关。ATE、脑梗死、出血性卒中和颈动脉疾病的风险相似。OSA患者在3年（HR 0.88[0.80-0.96]）和5年（HR 0.90[0.83-0.98]）的全因死亡率较低。在OSA患者中，CRVO的死亡率高于BRVO（1年：HR 1.50[1.20-1.89]；3年：HR 1.29[1.11-1.49]；5年：HR 1.33[1.18-1.51]）。
结论： 合并OSA识别出RVO患者中静脉血栓栓塞和心肌梗死风险更高的亚组。在该亚组内，CRVO可能比BRVO具有更高的全因死亡风险。
英文摘要
BACKGROUND: Systemic vascular risk stratification following retinal vein occlusion (RVO) remains limited. We evaluated whether comorbid obstructive sleep apnea (OSA) modifies thromboembolic risk following RVO.
METHODS: Retrospective cohort study using TriNetX Analytics Network. RVO patients with versus without prior OSA were matched 1:1 on demographics and comorbidities. Incident outcomes at 1, 3, and 5 years included hazard ratios (HR [95% confidence interval]) of anticoagulation initiation, composite venous thromboembolism (VTE; pulmonary embolism or deep vein thrombosis), myocardial infarction, composite arterial thromboembolism (ATE; cerebral infarction, transient ischemic attack, or arterial embolism), cerebral infarction, hemorrhagic stroke, carotid disease, and mortality. Secondary matched analysis compared central RVO (CRVO) versus branch RVO (BRVO) among OSA patients.
RESULTS: After matching, 10,728 patients remained per cohort. OSA was associated with increased anticoagulation initiation (1 year: HR 1.38 [1.18-1.61]; 3 years: HR 1.29 [1.16-1.44]; 5 years: HR 1.32 [1.19-1.45]), VTE (1 year: HR 1.48 [1.20-1.82]; 3 years: HR 1.46 [1.26-1.69]; 5 years: HR 1.44 [1.26-1.63]), and myocardial infarction (3 years: HR 1.21 [1.06-1.38]; 5 years: HR 1.17 [1.04-1.31]). ATE, cerebral infarction, hemorrhagic stroke, and carotid disease hazards were similar. All-cause mortality was lower among OSA patients at 3 years (HR 0.88 [0.80-0.96]) and 5 years (HR 0.90 [0.83-0.98]). Among OSA patients, CRVO showed higher mortality than BRVO (1 year: HR 1.50 [1.20-1.89]; 3 years: HR 1.29 [1.11-1.49]; 5 years: HR 1.33 [1.18-1.51]).
CONCLUSIONS: Comorbid OSA identifies a subgroup of RVO patients at higher hazard for venous thromboembolism and myocardial infarction. Within this subgroup, CRVO may carry higher all-cause mortality hazard than BRVO.