{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T14:30:26Z","timestamp":1793802626206,"version":"4.6.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Obstructive sleep apnea (OSA)\u2013chronic obstructive pulmonary disease overlap syndrome has been linked to worse cardiovascular outcomes. Preserved ratio impaired spirometry (PRISm) is recognized as an early stage of chronic obstructive pulmonary diseas. However, whether the coexistence of OSA and PRISm confers increased cardiovascular risk remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using data from the Sleep Heart Health Study, participants were categorized into 4 groups according to OSA and PRISm status. The primary outcome was major adverse cardiovascular and cerebrovascular events. The secondary outcome was cardiovascular disease mortality. Multivariable Cox regression models were used to evaluate the association of these groups with the risk of cardiovascular outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      During a median follow\u2010up of 11.45\u2009years, the incidence of major adverse cardiovascular and cerebrovascular events was 17.00% in non\u2010OSA with normal lung function, 27.52% in non\u2010OSA with PRISm, 25.28% in OSA with normal lung function, and 49.40% in OSA with PRISm. After multivariable adjustment, compared with non\u2010OSA with normal lung function, the adjusted hazard ratios (HRs) for major adverse cardiovascular and cerebrovascular events were 1.20 (95% CI, 0.82\u20131.75) in non\u2010OSA with PRISm, 1.04 (95% CI, 0.89\u20131.21) in OSA with normal lung function, and 1.52 (95% CI, 1.08\u20132.12) in OSA with PRISm. Corresponding HRs for CVD mortality were 2.02 (95% CI, 1.26\u20133.24), 1.05 (95% CI, 0.81\u20131.35), and 2.17 (95% CI, 1.41\u20133.34), respectively. A significant sex interaction was observed (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction=0.009), with the association present only in women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The coexistence of OSA and PRISm is independently associated with increased risk of adverse cardiovascular outcomes. This association is observed predominantly in women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.052921","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:55:14Z","timestamp":1791633314000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Effect of Obstructive Sleep Apnea and Preserved Ratio Impaired Spirometry on Cardiovascular Outcomes"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5252-7107","authenticated-orcid":false,"given":"Lida","family":"Chen","sequence":"first","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]},{"name":"Zhangzhou Affiliated Hospital of Fujian Medical University","place":["Zhangzhou, 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H.","family":"Ali","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]},{"name":"University of Sadat City","place":["Sadat City, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4045-4341","authenticated-orcid":false,"given":"Virend K.","family":"Somers","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, 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