Obstructive Sleep Apnoea is a Pulmonary Embolism severity risk factor

Introduction: Venous thromboembolic disease (VTE) is a frequent and potentially fatal disease. Recent evidence has identified Obstructive Sleep Apnoea (OSA) as an independent risk factor for pulmonary embolism (PE) but its impact on the severity is unknown. Aims and Objectives: To investigate whether OSA is associated with PE severity scores. Methods: We included patients with a first PE episode. The bronchial arterial obstruction index (AOI) was measured by computed tomography angiography. Simplified Geneva Prognostic Score (sGPS) and Pulmonary Embolism Severity Index (PESI) were performed at the time of the PE diagnosis. A home type 3 respiratory polygraphy was performed in all patients. Results: We included 120 patients. 55 patients (45.8%) had AHI>15h−1. There were a major proportion of moderate-severe OSA (AHI>15h−1) patients in the third and fourth AOI quartiles compared to AHI ≤15h-1 group (p = 0.037). The proportion of patients at different PESI levels was different according to the AHI classification; AHI>15h−1 patients were more frequent in the III-V classes (p = 0.033). Likewise, the mean adjusted values of the sGPS, PESI and AOI scores were higher in the AHI>15 h−1 group (p <0.05). Multiple linear regression analysis identified AHI as the only independent factor related to AOI, sGPS and PESI. Conclusions: Patients with PE with moderate-severe OSA (AHI>15h−1) had greater bronchial artery obstruction as well as more severity, assessed by both the sGPS and the PESI, compared with patients with AHI≤15h−1.