Can upper airway surgery for OSA protect against cardiovascular sequelae via effects on coagulation?

Abstract

Conclusion: Upper airway surgery is associated with salutary effects on the blood coagulation characteristics of OSA patients, a benefit that may be protective against cardiac and cerebrovascular morbidity and mortality. Objective: Increased blood coagulation is an important factor linking OSA and cardiovascular complications. Surgery is an important method to treat OSA, but the effect of surgery on blood coagulation in OSA patients is unknown. Methods: the authors performed a prospective clinical trial of adult OSA patients who underwent surgery from 2012–2014. Pre-operative and post-operative blood coagulation parameters and polysomnography (PSG) results were compared. Result: There were 61 subjects. The total rate of success in curing OSA was 11.5%. The rate of response after surgery was 40.8%. Overall, the Apnea-Hypopnea Index (AHI) improved after surgery (from 39.8 3 ± 24.49 to 25.9 7 ± 18.53, p < 0.01). After surgery, serum platelet counts (PLT) decreased (from 242.5 ± 52.6 to 230.9 ± 40.7, p=0.01), and Fibrinogen (FIB) levels declined (from 262.5 ± 52.5 to 247.3 ± 44.4, p = 0.02). Other blood coagulation parameters also improved: prothrombin time (PT) (from 10.6 2 ± 0.62 to 10.8 6 ± 0.70, p=0.01), activated partial thromboplastin time (APTT) (from 26.9 8 ± 4.94 to 27.7 8 ± 3.02, p = 0.06), and Thrombin time (TT) (from 19.5 3 ± 0.84 to 20.1 1 ± 1.31, p < 0.01).

Keywords:

• Obstructive sleep apnea (OSA)
• polysomnography
• blood coagulation
• upper airway surgery
• cardiovascular disease

Acknowledgments

The study was supported by The Capital Health Research and Development Fund, Special Grants, No.2011-2003-05 and Beijing Health Care Research Fund No. 2013-15. JMP received funding from the National Institute on Aging.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.