0428 Area Deprivation Index, Sleep Disordered Breathing and Incident Major Cardiovascular Events and Mortality in a Large Cohort

Abstract Introduction Epidemiological studies have shown a strong association between sleep disordered breathing (SDB) and increased incidence of cardiovascular morbidity mortality, however, to date, the variation SDB across socioeconomic spectrum how this is associated with major events (MACE) mortality unknown. Methods A retrospective cohort study was conducted using Cleveland Clinic Sleep Laboratory Registry included MACE-naïve adults who underwent polysomnography or home apnea test. Area Deprivation Index (ADI), biomarker neighborhood disadvantage, calculated by national rank, i.e. 25th, 50th 75th percentiles; higher quartiles reflecting greater deprivation (ADI-Q1,2,3,4). ANOVA pairwise testing used compare variables ADI quartiles. Composite MACE heart failure, stroke, atrial fibrillation myocardial Infarction death. Cox proportional hazard regression models tested SDB-measures hypopnea (AHI) sleep-related hypoxia (total time spent< 90%SaO2, T90) MACE. Covariates demographics, medications, smoking status, Elixhauser Comorbidity Score, comorbidities. Censoring date last encounter in electronic medical record. Asterisk (*) indicates statistical significance after testing. Interaction competing risk (Fine & Gray method). Results Of 72,443 patients, those living ADI-Q4, compared ADI-Q1, were more likely be younger (*48.9± 3.9 vs 50.4±14.2), female (*59.9% 40.1%), African American (*49% 4.9%), lower AHI (*13.5[5.4, 34.1]vs15.1[6.2,33.1]) degree (T90:*2.9[0.40,19.01] 4.4[0.50, 25.6]). Model adjusted for death ADI-Q4 79% than ADI-Q1 (HR=1.79,95%CI:1.51-2.12,p< 0.0001). Likewise, severity T90 above median 13% 21% (HR=1.13,95%CI:1.07-1.19,p< 0.0001; HR=1.21,95%CI:1.51-1.27,p< 0.001) respectively. Interactions observed (p=0.0016) (p=0.0051). Conclusion Living areas increasing confers an Moreover, seems modify association. appears useful identify populations at worse outcomes inform stratification targeted interventions decreased sleep-health disparities. Support (if any)