Sleep apnea and venous thromboembolism

Giuseppe Lippi; Camilla Mattiuzzi; Massimo Franchini

doi:10.1160/TH15-03-0188

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 114(05): 958-963
DOI: 10.1160/TH15-03-0188

Review Article

Schattauer GmbH

Sleep apnea and venous thromboembolism

A systematic review

Giuseppe Lippi

¹Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy

,

Camilla Mattiuzzi

²Service of Clinical Governance, General Hospital of Trento, Trento, Italy

,

Massimo Franchini

³Department of Hematology and Transfusion Medicine, C. Poma Hospital, Mantova, Italy

› Author Affiliations

Abstract

Summary

Recent evidence suggests that obstructive sleep apnea is a significant and independent risk factor for a number of cardiovascular disorders. Since the association between obstructive sleep apnea and cardiovascular disease is mediated by endothelial dysfunction, hypercoagulability and platelet abnormalities, we sought to investigate whether sleep apnea may also be considered a risk factor for venous thromboembolism (VTE). We carried out an electronic search in Medline and Scopus using the keywords “apnea” OR “apnoea” AND “venous thromboembolism” OR “deep vein thrombosis” OR “pulmonary embolism” in “Title/Abstract/Keywords”, with no language or date restriction. Fifteen studies (8 case-control, 4 retrospective observational, 2 prospective case-control and 1 prospective observational) were finally selected for this systematic review. In all studies except one (14/15; 93%), obstructive sleep apnea was found to be an independent risk factor for VTE, either deep-vein thrombosis (DVT) or pulmonary embolism (PE). In the two prospective case-control studies the risk of DVT or PE was found to be two-to three-fold higher in patients with obstructive sleep apnea than in those without. In conclusion, the current epidemiological evidence supports the hypothesis that obstructive sleep apnea may be an independent risk factor for VTE.

Keywords

Venous thromboembolism - thrombosis - sleep apnea - risk

Full Text

References

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