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Volume 15 No. 10
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Accepted Papers

Scientific Investigations

The Clinical Value of N-Terminal Pro B-Type Natriuretic Peptide in Evaluating Obstructive Sleep Apnea in Patients With Coronary Artery Disease

Yuanhui Liu, MD1,*; Zhihua Huang, MD1,2,*; Kaizhuang Huang, MD1,2; Guang Li, MD1; Jianfang Luo, MD1; Ying Xu, MD3; Pingyan Chen, MD3; Jiyan Chen, MD, PhD1; Ling Wang, MD1
1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; 2Shantou University Medical College, Shantou, China; 3Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China; *Co-first authors

Study Objectives:

Natriuretic peptides have been identified as biomarkers of increased myocardial wall stress in the context of obstructive sleep apnea (OSA) in the general population. However, the relationship between N-terminal pro B-type natriuretic peptide (NT-proBNP) and OSA remains unclear in patients with coronary artery disease (CAD). Hence, we aimed to investigate the clinical value of NT-proBNP in evaluating OSA in a large population of patients with CAD.


Consecutive patients with CAD were prospectively enrolled between February 2015 and March 2018. Portable respiratory monitoring was applied to facilitate the diagnosis of sleep apnea. Patients were as assigned to the non-OSA (when the respiratory events index [REI] or 3% oxygen desaturation index [ODI] < 15 events/h) and OSA (when the REI or 3% ODI ≥ 15 events/h) groups. Multivariate analyses were used to explore the independent association between NT-proBNP levels and OSA.


A total of 1,292 consecutive patients were included with a mean NT-proBNP value of 826.57 μg/L. Patients with high levels of NT-proBNP experienced increasing severity of OSA in those with CAD (P = .0004). Univariate analysis demonstrated that NT-proBNP was a risk factor for OSA (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.03–1.18, P = .005). In addition, multivariate analysis revealed that NT-proBNP was independently associated with the presence of OSA (OR 1.11, 95% CI 1.02–1.20, P = .012) even after adjusting for other cofounding factors.


Elevated levels of NT-proBNP were independently associated with a higher likelihood of OSA in patients with CAD. Periodically screening for NT-proBNP levels may provide early identification of OSA.


Liu Y, Huang Z, Huang K, Li G, Luo J, Xu Y, Chen P, Chen J,Wang L. The clinical value of n-terminal pro b-type natriuretic peptide in evaluating obstructive sleep apnea in patients with coronary artery disease. J Clin Sleep Med. 2019;15(10):1403–1409.

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