Sleep Apnea Is Prevalent Among Cardio-Oncology Patients

Obstructive sleep apnea (OSA) is prevalent among cardio-oncology patients at increased risk for congestive heart failure from cancer therapy, according to a recent study being presented at the American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient course.

OSA maintains a 48% to 52% prevalence in heart failure patients, and it is associated with heightened cardiovascular mortality and morbidity rates, the researchers noted. Cardio-oncology patients have a higher risk of congestive heart failure from cancer therapy, but less is known about the prevalence of sleep apnea in this group. “Echocardiogram has evolved to be a useful tool to detect and therefore treat cardiomyopathy early in patients with sleep apnea and in the cardio-oncology population, so we also wanted to see if there are shared echo markers that identify patients who are at greater risk as they start their journey to treat their cancer,” said Mini K. Das, MD, medical director of the Cardio-Oncology Program at Baptist Health in Louisville, Kentucky, and the study’s primary author, via a press release.

Researchers employed a questionnaire to assess the prevalence of sleep apnea among 296 general cardiology patients and 218 cardio-oncology patients. Data were collected on traditional risk factors, STOP-BANG scores, and history of sleep for both groups. At baseline, researchers also measured echocardiogram left ventricular (LV) ejection fraction and global longitudinal LV strain.

Incidence of sleep apnea was 54% in the general cardiology group and 39% in the cardio-oncology group. The prevalence of sleep apnea in the general cardiology group was similar to reported rates in patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF), where the rates were 52% and 48% with HFrEF and HFpEF, respectively.

Responses to the questionnaire showed that individuals with untreated sleep apnea and those at higher risk for sleep apnea have abnormal baseline LV strain.

“Sleep apnea should be incorporated into current risk algorithms, and a larger study is needed to evaluate the impact of sleep apnea in this high-risk population,” Dr. Das said. “Identifying these individuals may allow early intervention in a risk factor clearly associated with heart failure now recognized to affect cancer therapy and survivorship.”