Detection rate and risk factors of carotid atherosclerotic plaque in patients with obstructive sleep apnea syndrome: A systematic review and meta-analysis.
Kangyu Shao, Tao Hu, Yongping Yao et al.
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In 30 seconds
This systematic review and meta-analysis examined carotid atherosclerotic plaque (CAP) detection and associated factors in patients with obstructive sleep apnea syndrome (OSAS), including 37 studies. The pooled CAP detection rate was 36.85% (95% CI, 29.92% to 44.37%), with substantial heterogeneity (I² = 95.8%). Detection increased across mild, moderate, and severe OSAS groups, at 27.68%, 42.13%, and 47.36%, respectively. Age, sex, smoking history, hypertension, type 2 diabetes, and hyperlipidemia were associated with CAP detection; meta-regression also found higher detection rates with increasing age.
Key findings
- Across 37 studies, pooled CAP detection in OSAS was 36.85% (95% CI, 29.92% to 44.37%; I² = 95.8%).
- CAP detection rose across mild, moderate, and severe OSAS groups: 27.68%, 42.13%, and 47.36%, respectively.
- Age, sex, smoking history, hypertension, type 2 diabetes, and hyperlipidemia were associated with CAP detection.
- Meta-regression found detection increased with age (β = 0.0788, P = 0.0002); publication year, AHI, BMI, and T90% were not significant moderators.
Why it matters
The findings indicate that carotid plaque is frequently detected in OSAS and that detection varies with disease severity and patient characteristics. This supports awareness of coexisting vascular disease when assessing OSAS populations. However, the substantial between-study heterogeneity means the pooled estimate should not be treated as a precise rate applicable to every clinical setting.
What to keep in mind
Heterogeneity was substantial (I² = 95.8%), and reporting heterogeneity restricted the systematic review of risk factors. The findings describe detection and associations, not causal effects.