Homocystinuria: A new inborn error of Metabolism associated with Mental Deficiency

Abstract

<b>Background:</b> We have previously found that both obstructive sleep apnea (OSA) and central sleep apnea (CSA) have high prevalence in hospitalized patients with heart failure with reduced ejection fraction (HFrEF) and that SDB predicted post discharge mortality and readmissions. The role of SDB in post discharge outcomes in patients with HFpEF remains less well understood. <b>Methods:</b> We used an established inception prospective cohort of hospitalized heart failure patients who had inpatient testing for SDB (The OSU-Sleep Heart Program) to identify a subgroup of HFpEF (EF &lt; 45%) who underwent sleep testing. Patients who underwent sleep studies had their readmissions and vital status tracked post discharge. <b>Results:</b> Between 2009 and 2013, 1569 patients admitted for heart failure underwent sleep studies during hospitalization. Of those, 400 had HFpEF. 69 (17.3%) patients had CSA, and 204 (51%) had OSA. The remainder had no SDB (apnea hypopnea index &lt;15) (Table-1) The rate ratio for 6 month readmissions was 3.22 (95% CI 1.66, 6.25) (p&lt;0.001) in CSA patients compared to no SDB. This rate ratio is adjusted for age, sex, diabetes, chronic kidney disease and coronary artery disease. The adjusted rate ratio for 6 month readmissions was 2.08 (95% CI 1.23, 3.5) (p=0.01) in OSA patients compared no SDB (Table-2). <b>Conclusion:</b> In hospitalized HFpEF patients, OSA was more prevalent that CSA. Similar to patients with HFrEF, both OSA and CSA were independent predictors of readmissions.