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Does OSA hypercoagulability operates through Protein C and S pathways?
To unravel the underlying pathology of thrombosis in OSA patients.
BACKGROUND: Obstructive sleep apnea (OSA) is associated with death from cardiovascular diseases, including myocardial infarction and stroke. A significant proportion of patients with OSA have thrombotic complications, therefore, investigators have tried to delineate relationships between OSA and atherosclerosis.
OSA may accelerate atherosclerosis by exacerbating different thrombotic mechanism. Proteins C and S are two vitamin K-dependent plasma proteins. The anticoagulant activity is through the selective inactivation of Factors Va and VIIIa. Many patients deficient in proteins C and S have an associated thrombotic tendency. The deficiency of protein C and protein S should be considered as a risk factor for thrombotic disease.
DESIGN/METHODS: All the adult patients examined at Ayass Lung Clinic & Sleep Center who consented for the blood tests were included in the study in 2013. Demographic, laboratory and clinical information were obtained from medical records. We performed a retrospective cross sectional study of the prevalence of protein c deficiency and protein s deficiency in 122 OSA patients and 271 patients without OSA as controls.
Twenty six (6%) of the study population were pc deficient and ps deficient. There was a significant increase in mean value for Pc and Ps antibodies in OSA vs non OSA. The levels of D-D, factor 8, Ps, and Pc, were (310) mg/L, (142) %, (120) (106) % respectively in patients with OSA and (406) mg/L, (136) %, (111) % and (99) % in patients without OSA. The rate of change of protein c mean with respect to OSA was significantly 7 after controlling for confounders.
These results suggest the association of OSA with disturbance of blood coagulation and this finding urge further investigation by conducting a larger population study.