Greater OSA severity is independently associated with increased levels of high-sensitivity troponin T (hs-TnT), suggesting a role for subclinical myocardial injury in the relationship between OSA and heart failure, according to research published online ahead of print in the American Journal of Respiratory and Critical Care Medicine.

Researchers note that hs-TnT levels are predictive of both coronary heart disease (CHD) and heart failure (HF) in the general population.

After participants underwent overnight home polysomnography, median follow-up was 12.4 years. OSA severity was categorized as none, mild, moderate, or severe, using the respiratory disturbance index.

Investigators found hs-TnT levels were significantly associated with OSA after adjustment for 17 potential confounders including age, gender, body mass index, smoking status, hypertension, diabetes, alcohol intake, and pulmonary function variables. In all OSA severity categories, hs-TnT was significantly related to the risk of death or incident heart failure, and this relationship was strongest in the severe OSA group.

“Our results suggest a relationship between subclinical myocardial injury and the increased cardiovascular risk seen in patients with OSA,” said Amil M. Shah, MD, MPH, of the Brigham and Women’s Hospital in Boston. “Monitoring of hs-TnT levels in these patients may have prognostic value, particularly in patients with severe OSA.”