Hypoxemia During Sleep and the Progression of Coronary Artery Calcium

Min Young Seo, Seung Hoon Lee, Sang Duk Hong, Seung Kyu Chung, Hyo Yeol Kim

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


The aim of this study was to evaluate the associations between objective sleep parameters of obstructive sleep apnea (OSA) and progression of subclinical cardiovascular disease as measured by the coronary artery calcium (CAC) score. We reviewed the medical records of 196 patients who underwent both polysomnography (PSG) and repeated coronary artery computed tomography (CT) for screening purposes. For each participant, the first coronary CT scan was conducted within 12 months of PSG. Follow-up CT was performed voluntarily. The CAC score was log-transformed to obtain normally distributed data. We evaluated potential associations between various sleep parameters by analyzing overnight-attended PSG and CAC score progression over time. ST90 (total sleep time of SaO2 < 90%), CT90 (percentage of time of SaO2 < 90%), and degree of mean oxygen desaturation were significantly correlated with CAC score progression even after adjustment for confounders (age, sex, DM, HTN, hypercholesterolemia, BMI, and smoking status) (estimate = 0.004, p =.010; estimate = 0.009, p <.001; estimate = 0.027, p =.001; respectively). We also performed subgroup analysis and found that the progression of CAC score over time showed higher tendency when CT90 value was 2.73 or more (CT90 ≥ 2.73 group; estimate = 0.336, CT90 < 2.73 group; estimate = 0.194, p <.001 each). ST90, CT90 and mean oxygen desaturation are significant predictors of cardiovascular disease progression. Coronary artery status should be monitored repetitively in patients with hypoxemia during sleep.

Original languageEnglish
Pages (from-to)42-48
Number of pages7
JournalCardiovascular Toxicology
Issue number1
Publication statusPublished - 2021 Jan
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by National Research Foundation of Korea (NRF) grant funded by Korean government (MEST) (2017R1A2B4006453) and National Research Foundation of Korea (NRF) grant funded by Korean government (Ministry of Education) (NRF-2020R1I1A1A01063604).

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.


  • Coronary artery calcium
  • Hypoxemia during sleep
  • Obstructive sleep apnea
  • Subclinical cardiovascular disease

ASJC Scopus subject areas

  • Molecular Biology
  • Toxicology
  • Cardiology and Cardiovascular Medicine


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