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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
1   Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
,
Camilla Mattiuzzi
2   Service of Clinical Governance, General Hospital of Trento, Trento, Italy
,
Massimo Franchini
3   Department of Hematology and Transfusion Medicine, C. Poma Hospital, Mantova, Italy
› Author Affiliations
Further Information

Publication History

Received: 02 March 2015

Accepted after major revision: 16 April 2015

Publication Date:
06 December 2017 (online)

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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
 

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