Prothrombotic Factors in Obstructive Sleep Apnea: A Systematic Review With Meta-Analysis

Ear Nose Throat J. 2022 Nov;101(9):NP412-NP421. doi: 10.1177/0145561320965208. Epub 2020 Nov 9.

Abstract

Background: Previous studies revealed that the prothrombotic factors in patients with obstructive sleep apnea (OSA) remain controversial.

Aim/objective: The aim of the systematic review is to elucidate the relationship between prothrombotic factors and OSA.

Materials and methods: This systematic review was performed under the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The literature we investigated was extracted from 4 main medical databases (PubMed, Web of Science, Cochrane Library, and Chinese databases) as of February 2020. We used significant weighted mean differences (SMDs) with 95% CIs from random-effects model.

Results: A total of 15 studies comprising 2190 patients were available for the meta-analysis. The pooled results showed that the levels of fibrinogen (SMD = 0.95, 95% CI = 0.26 to 1.65, P = .000), vascular endothelial growth factor (SMD = 0.37, 95% CI = -0.90 to 1.63, P = .000), and plasminogen activator inhibitor 1 (SMD = 0.61, 95% CI = 0.29 to 0.92, P = .040) increased in patients with OSA. There were no statistical differences between groups in terms of d-dimer (P = .108) and platelet counts (P = .233). Subgroup analyses demonstrated that specimen types and age could account for the heterogeneity.

Conclusions and significance: This meta-analysis indicated the relationship between prothrombotic factors in OSA hypopnea. Obstructive sleep apnea-related effects may underline the importance of considering the dysfunction of the hemostatic system. The prothrombotic factors in OSA can influence making a choice of appropriate therapy.

Keywords: cardiovascular; meta-analysis; obstructive sleep apnea; prothrombotic factors.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Hemostatics*
  • Humans
  • Plasminogen Activator Inhibitor 1
  • Sleep Apnea, Obstructive*
  • Vascular Endothelial Growth Factor A

Substances

  • Hemostatics
  • Plasminogen Activator Inhibitor 1
  • Vascular Endothelial Growth Factor A