Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
March-2023 Volume 25 Issue 3

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
March-2023 Volume 25 Issue 3

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML

  • Supplementary Files
    • Supplementary_Data.pdf
Article Open Access

Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis

  • Authors:
    • Wen Zhang
    • Yongmin Ding
  • View Affiliations / Copyright

    Affiliations: Department of Pulmonary and Critical Care Medicine, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch) Shengzhou, Zhejiang 312400, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 120
    |
    Published online on: February 1, 2023
       https://doi.org/10.3892/etm.2023.11819
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

The current review aimed to assess the effect of obstructive sleep apnea (OSA) on the severity and outcomes of pulmonary embolism (PE). PubMed, Embase, ScienceDirect, CENTRAL and Google Scholar were searched for studies assessing the impact of OSA on severity and outcomes of PE. A total of 12 studies were included. Meta‑analysis revealed that simplified PE severity index of >1 and pulmonary artery obstruction index score was significantly higher in patients with OSA as compared with controls, but there was no difference in right ventricle to left ventricle short‑axis diameter. The need for non‑invasive ventilation was significantly higher in patients with OSA but there was no difference in the need for mechanical ventilation. Patients with OSA had a significantly higher incidence of recurrence of PE. Meta‑analysis also showed a statistically significantly lower risk of in‑hospital mortality in patients with OSA as compared with controls, but without any difference in the risk of late mortality. Adjusted data on mortality indicated a significantly lower risk of mortality in PE patients with comorbid OSA. Limited data shows that comorbid OSA increases the severity of PE but has no effect on right ventricular function. OSA may increase the risk of recurrent PE. Paradoxically, the presence of OSA may also reduce the risk of in‑hospital mortality. Results must be interpreted with caution owing to high inter‑study heterogeneity and lack of matching of baseline characteristics. Current evidence needs to be confirmed by high‑quality prospective studies.
View Figures

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

View References

1 

Stein PD, Matta F and Hughes MJ: Hospitalizations for high-risk pulmonary embolism. Am J Med. 134:621–625. 2021.PubMed/NCBI View Article : Google Scholar

2 

Becattini C and Agnelli G: Risk stratification and management of acute pulmonary embolism. Hematology Am Soc Hematol Educ Program. 2016:404–412. 2016.PubMed/NCBI View Article : Google Scholar

3 

Casazza F, Becattini C, Bongarzoni A, Cuccia C, Roncon L, Favretto G, Zonzin P, Pignataro L and Agnelli G: Clinical features and short term outcomes of patients with acute pulmonary embolism. The Italian pulmonary embolism registry (IPER). Thromb Res. 130:847–852. 2012.PubMed/NCBI View Article : Google Scholar

4 

Elias A, Mallett S, Daoud-Elias M, Poggi JN and Clarke M: Prognostic models in acute pulmonary embolism: A systematic review and meta-analysis. BMJ Open. 6(e010324)2016.PubMed/NCBI View Article : Google Scholar

5 

Patel SR: Obstructive sleep apnea. Ann Intern Med. 171:ITC81–ITC96. 2019.PubMed/NCBI

6 

Diamond JA and Ismail H: Obstructive sleep apnea and cardiovascular disease. Clin Geriatr Med. 37:445–456. 2021.PubMed/NCBI View Article : Google Scholar

7 

Alonso-Fernández A, Toledo-Pons N and García-Río F: Obstructive sleep apnea and venous thromboembolism: Overview of an emerging relationship. Sleep Med Rev. 50(101233)2020.PubMed/NCBI View Article : Google Scholar

8 

Geissenberger F, Schwarz F, Probst M, Haberl S, Parkhe A, Faul C, von Lewinski D, Kroencke T, Schwaiblmair M, von Scheidt W and Berghaus TM: Obstructive sleep apnea is associated with pulmonary artery thrombus load, disease severity, and survival in acute pulmonary embolism. Clin Res Cardiol. 109:13–21. 2020.PubMed/NCBI View Article : Google Scholar

9 

Berghaus TM, Geissenberger F, Konnerth D, Probst M, Kröncke T and Schwarz F: Right-to-left ventricular diameter ratio at computed tomographic pulmonary angiography in patients with acute pulmonary embolism and obstructive sleep apnea. Clin Med Insights Circ Respir Pulm Med. 14(1179548420976430)2020.PubMed/NCBI View Article : Google Scholar

10 

Joshi AA, Hajjali RH, Gokhale AV, Smith T, Dey AK, Dahiya G, Lerman JB, Sajja AP, Kanwar M and Raina A: Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status. Pulm Circ. 11(2045894021996224)2021.PubMed/NCBI View Article : Google Scholar

11 

Xu J, Wang X, Meng F, Zhao T, Tang T, Wu W and Wang W: The role of obstructive sleep apnea on the prognosis of pulmonary embolism: A systemic review and meta-analysis. Sleep Breath. 25:1419–1426. 2021.PubMed/NCBI View Article : Google Scholar

12 

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al: The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Int J Surg. 88(105906)2021.PubMed/NCBI View Article : Google Scholar

13 

Wells G, Shea B, O'Connell D, Peterson J, Welch V, Losos M and Tugwell P: The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, 2013.

14 

Zhang XF, Gao YM, Zhu GF, Yang JH, Ding SF and Liu S: Obstructive sleep apnea-hypopnea syndrome in patients with pulmonary thromboembolism: Clinical features and management. Zhonghua Jie He He Hu Xi Za Zhi. 35:180–183. 2012.PubMed/NCBI(In Chinese).

15 

de-Miguel-Diez J, Lopez-Herranz M, Hernandez-Barrera V, Jimenez D, Monreal M, Jiménez-García R and López-de-Andrés A: Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality. Sci Rep. 11(18390)2021.PubMed/NCBI View Article : Google Scholar

16 

Le Mao R, Jiménez D, Bikdeli B, Porres-Aguilar M, García-Ortega A, Rosa V, Schellong S, Mazzolai L, Rivera-Civico F and Monreal M: RIETE Investigators. Prognostic impact of obstructive sleep apnea in patients presenting with acute symptomatic pulmonary embolism. Thromb Haemost. 121:808–815. 2021.PubMed/NCBI View Article : Google Scholar

17 

Seckin ZI, Helmi H, Weister TJ, Lee A and Festic E: Acute pulmonary embolism in patients with obstructive sleep apnea: Frequency, hospital outcomes, and recurrence. J Clin Sleep Med. 16:1029–1036. 2020.PubMed/NCBI View Article : Google Scholar

18 

Toledo-Pons N, Alonso-Fernández A, de la Peña M, Pierola J, Barceló A, Fernández-Capitán C, Lorenzo A, Mejía Núñez JA, Carrera M, Soriano JB, et al: Obstructive sleep apnea is associated with worse clinical-radiological risk scores of pulmonary embolism. J Sleep Res. 29(e12871)2020.PubMed/NCBI View Article : Google Scholar

19 

Xiao Y, Yang LR, Zhu GF, Zhang Y, Wu CT and Zhang WM: Effect of obstructive sleep apnea on the severity of acute pulmonary thromboembolism. Zhonghua Yi Xue Za Zhi. 99:739–743. 2019.PubMed/NCBI View Article : Google Scholar : (In Chinese).

20 

Konnerth D, Schwarz F, Probst M, Seidler M, Wagner T, Faul C, von Scheidt W, Schwaiblmair M and Berghaus TM: Is acute pulmonary embolism more severe in the presence of obstructive sleep apnea? Results from an observational cohort study. J Thromb Thrombolysis. 46:253–259. 2018.PubMed/NCBI View Article : Google Scholar

21 

Alonso-Fernández A, Suquia AG, de la Peña M, Casitas R, Pierola J, Barceló A, Soriano JB, Fernández-Capitán C, Martinez-Ceron E, Carrera M and García-Río F: OSA Is a risk factor for recurrent VTE. Chest. 150:1291–1301. 2016.PubMed/NCBI View Article : Google Scholar

22 

Xie J, Wei YX, Liu S, Zhang W, Zhang XF and Li J: Obstructive sleep apnea hypopnea syndrome as a reason for active management of pulmonary embolism. Chin Med J (Engl). 128:2147–2153. 2015.PubMed/NCBI View Article : Google Scholar

23 

Piazza G: Submassive pulmonary embolism. JAMA. 309:171–180. 2013.PubMed/NCBI View Article : Google Scholar

24 

Zhou XY, Ben SQ, Chen HL and Ni SS: The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: A meta-analysis. Respir Res. 13(111)2012.PubMed/NCBI View Article : Google Scholar

25 

Venetz C, Jiménez D, Méan M and Aujesky D: A comparison of the original and simplified pulmonary embolism severity index. Thromb Haemost. 106:423–428. 2011.PubMed/NCBI View Article : Google Scholar

26 

Guo F, Zhu G, Shen J and Ma Y: Health risk stratification based on computed tomography pulmonary artery obstruction index for acute pulmonary embolism. Sci Rep. 8(17897)2018.PubMed/NCBI View Article : Google Scholar

27 

Testelmans D, Spruit MA, Vrijsen B, Sastry M, Belge C, Kalkanis A, Gaffron S, Wouters EFM and Buyse B: Comorbidity clusters in patients with moderate-to-severe OSA. Sleep Breath. 26:195–204. 2022.PubMed/NCBI View Article : Google Scholar

28 

Ng ACC, Chow V, Yong ASC, Chung T and Kritharides L: Prognostic impact of the Charlson comorbidity index on mortality following acute pulmonary embolism. Respiration. 85:408–416. 2013.PubMed/NCBI View Article : Google Scholar

29 

Hong SN, Yun HC, Yoo JH and Lee SH: Association between hypercoagulability and severe obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg. 143:996–1002. 2017.PubMed/NCBI View Article : Google Scholar

30 

Palareti G: How D-dimer assay can be useful in deciding the duration of anticoagulation after venous thromboembolism: A review. Expert Rev Hematol. 8:79–88. 2015.PubMed/NCBI View Article : Google Scholar

31 

Akyol S, Cortuk M, Baykan AO, Kiraz K, Borekci A, Seker T, Gur M and Cayli M: Biventricular myocardial performance is impaired in proportion to severity of obstructive sleep apnea. Texas Hear Inst J. 43:119–125. 2016.PubMed/NCBI View Article : Google Scholar

32 

Ende-Verhaar YM, Kroft LJM, Mos ICM, Huisman MV and Klok FA: Accuracy and reproducibility of CT right-to-left ventricular diameter measurement in patients with acute pulmonary embolism. PLoS One. 12(e0188862)2017.PubMed/NCBI View Article : Google Scholar

33 

Sajkov D and McEvoy RD: Obstructive sleep apnea and pulmonary hypertension. Prog Cardiovasc Dis. 51:363–370. 2009.PubMed/NCBI View Article : Google Scholar

34 

Wong LF, Akram AR, McGurk S, Van Beek EJR, Reid JH and Murchison JT: Thrombus load and acute right ventricular failure in pulmonary embolism: correlation and demonstration of a ‘tipping point’ on CT pulmonary angiography. Br J Radiol. 85:1471–1476. 2012.PubMed/NCBI View Article : Google Scholar

35 

Ho KS, Wu L, Sheehan J and Salonia J: Obesity paradox? Improved in-hospital mortality in patients admitted for sepsis vs septic shock: A propensity score match analysis. Chest. 156 (Suppl 1)(A1141)2019.

36 

Niedziela J, Hudzik B, Niedziela N, Gąsior M, Gierlotka M, Wasilewski J, Myrda K, Lekston A, Poloński L and Rozentryt P: The obesity paradox in acute coronary syndrome: A meta-analysis. Eur J Epidemiol. 29:801–812. 2014.PubMed/NCBI View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Zhang W and Ding Y: Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis. Exp Ther Med 25: 120, 2023.
APA
Zhang, W., & Ding, Y. (2023). Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 25, 120. https://doi.org/10.3892/etm.2023.11819
MLA
Zhang, W., Ding, Y."Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 25.3 (2023): 120.
Chicago
Zhang, W., Ding, Y."Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 25, no. 3 (2023): 120. https://doi.org/10.3892/etm.2023.11819
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang W and Ding Y: Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis. Exp Ther Med 25: 120, 2023.
APA
Zhang, W., & Ding, Y. (2023). Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 25, 120. https://doi.org/10.3892/etm.2023.11819
MLA
Zhang, W., Ding, Y."Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 25.3 (2023): 120.
Chicago
Zhang, W., Ding, Y."Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 25, no. 3 (2023): 120. https://doi.org/10.3892/etm.2023.11819
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team