Effect of OSA on severity and clinical outcomes of patients with Acute Pulmonary Embolism (PE)

<bold>Background:</bold> The effect of OSA on the severity and prognosis of PE remains unclear. <bold>Aims and Objectives:</bold> To investigate the association between OSA and severity as well as clinical outcomes of patients with acute PE. <bold>Methods:</bold> A prospective study of patients who underwent type I polysomnography 2 months after acute stable PE. The simplified Pulmonary Embolism Severity Index (sPESI) was used to evaluate acute PE severity. Associations between indexes of OSA severity and risk of belonging to sPESI≥1 group were investigated, after adjustments for confounders. PAP therapy was administered to all patients with OSA. Cox regression analysis was used to examine the relationship between OSA severity and long-term cardiovascular (CV) events. <bold>Results:</bold> Of the 57 patients with acute PE (mean age 63 years), 60% had OSA (AHI≥5). OSA patients had a significantly higher rate of sPESI≥1 (77% vs. 57%, p=0.003). All indexes of OSA severity (AHI, ODI, mean and lowest SaO2 and TST90) were independently associated with increased risk of severe PE (sPESI≥1) (all p<0.05). During an average follow-up of 22 months, 12% of patients experienced CV complications, with reduced PAP use (<6 hours/day) as a significant predictor (OR: 1.59; 95% CI 1.19–1.86; p=0.002). <bold>Conclusion:</bold> OSA is a common disease in patients with acute PE and is associated with increased OSA severity, while reduced adherence to OSA treatment is associated with an increased risk of cardiovascular complications. The implementation of routine OSA screening and management could potentially contribute to risk stratification and improve outcomes among acute PE patients.