What is the clinical evidence from this study?

Study design: Observational. Population: Percutaneous coronary intervention with obstructive sleep apnea (n=4792177). Intervention: OSA-COPD overlap syndrome vs. OSA alone. Primary outcome: All-cause in-hospital mortality (OR 1.21, 95% CI 1.11-1.32, p=<0.001).

What does this research mean for the field?

In patients with obstructive sleep apnea undergoing percutaneous coronary intervention, concomitant COPD and obesity hypoventilation syndrome worsen clinical outcomes, with obesity hypoventilation syndrome conferring the highest risk of mortality and complications. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 7, 2022CureusOpen Access

Comparison of Percutaneous Coronary Intervention Outcomes Among Patients With Obstructive Sleep Apnea, Chronic Obstructive Pulmonary Disease Overlap, and Pickwickian Syndrome (Obesity Hypoventilation Syndrome)

Q: What are the key findings of this study?

In patients undergoing percutaneous coronary intervention, concomitant OSA-COPD overlap syndrome significantly increased the odds of in-hospital mortality compared to OSA alone (OR 1.21), and OSA with obesity hypoventilation syndrome was associated with the highest unadjusted mortality (2.8% vs 1.1%).

Q: What does this research mean for the field?

In patients with obstructive sleep apnea undergoing percutaneous coronary intervention, concomitant COPD and obesity hypoventilation syndrome worsen clinical outcomes, with obesity hypoventilation syndrome conferring the highest risk of mortality and complications. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

OSA-COPD overlap syndrome linked to ~21% higher in-hospital mortality versus OSA alone after PCI.

OR 1.21
95% CI 1.11-1.32
P<0.001
n=4,792,177

Why the study?

The impact of COPD and obesity hypoventilation syndrome in OSA patients undergoing PCI had never been studied.

Does the presence of concomitant COPD or obesity hypoventilation syndrome worsen clinical outcomes in patients with obstructive sleep apnea undergoing PCI?

Population

4,792,177 PCI-related inpatient encounters including 153,706 OSA, 65,135 OSA-COPD overlap, and 2,291 OSA+OHS patients

Comparison

OSA+OHS vs OSA-COPD overlap vs OSA alone

Design

Observational study using National Inpatient Sample (2007-2014)

Follow-up

In-hospital

Authors

RDRupak Desai SSSonali Sachdeva AJAkhil Jain

Discussion

Member takes

Overview

May warrant heightened periprocedural vigilance in OSA patients with COPD or obesity hypoventilation syndrome undergoing PCI; leaves open whether interventions modify outcomes.

Study Design

Type

Observational (n=4,792,177)

Multicenter

Yes

Structured PICO

Does the presence of concomitant COPD or obesity hypoventilation syndrome worsen clinical outcomes in patients with obstructive sleep apnea undergoing PCI?

Population

4,792,177 adult hospitalizations for percutaneous coronary intervention, including patients with obstructive sleep apnea alone or overlapping with COPD or obesity hypoventilation syndrome, analyzed for in-hospital outcomes.

Exposure

Presence of concomitant obesity hypoventilation syndrome (OHS) or chronic obstructive pulmonary disease (COPD) in patients with OSA undergoing PCI

Comparator

Patients with OSA alone undergoing PCI

Outcome

In-hospital all-cause mortality, hospital stay duration, hospital charges, and procedural complications (cardiogenic shock, post-procedural myocardial infarction, iatrogenic cardiac complications)hard clinical

Main Result

Odds Ratio: 1.21 (95% CI 1.11–1.32)

Absolute Event Rate: 1.5% vs 1.1%

p-value: p=<0.001

Concomitant obesity hypoventilation syndrome or COPD significantly increases the risk of in-hospital mortality, complications, and resource utilization in patients with obstructive sleep apnea undergoing PCI.

Limitations

Retrospective study based on administrative ICD-9 CM coding runs the risk of underreporting or overreporting
Only reports in-patient outcomes without long-term follow-up or functional outcomes
Lack of arterial blood gas, laboratory, medication, and echocardiographic data
Severity of OSA, OSA-COPD, and OHS was not known before PCI
Potential residual confounding due to retrospective nature and variation in hospital care
Lack of long-term outcomes

Cite This Study

Desai et al. (2022) conducted an observational in Percutaneous coronary intervention with obstructive sleep apnea (n=4,792,177). OSA-COPD overlap syndrome vs. OSA alone was evaluated on All-cause in-hospital mortality (OR 1.21, 95% CI 1.11-1.32, p=<0.001). In patients undergoing percutaneous coronary intervention, concomitant OSA-COPD overlap syndrome significantly increased the odds of in-hospital mortality compared to OSA alone (OR 1.21), and OSA with obesity hypoventilation syndrome was associated with the highest unadjusted mortality (2.8% vs 1.1%).

synapsesocial.com/papers/6aace40ed0cf774bc88583f2 https://doi.org/10.7759/cureus.24816

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May 7, 2022CureusOpen Access

Comparison of Percutaneous Coronary Intervention Outcomes Among Patients With Obstructive Sleep Apnea, Chronic Obstructive Pulmonary Disease Overlap, and Pickwickian Syndrome (Obesity Hypoventilation Syndrome)

View Full Paper

Ask AI

Bookmark

Key result

OSA-COPD overlap syndrome linked to ~21% higher in-hospital mortality versus OSA alone after PCI.

OR 1.21
95% CI 1.11-1.32
P<0.001
n=4,792,177

Why the study?

The impact of COPD and obesity hypoventilation syndrome in OSA patients undergoing PCI had never been studied.

Does the presence of concomitant COPD or obesity hypoventilation syndrome worsen clinical outcomes in patients with obstructive sleep apnea undergoing PCI?

Population

4,792,177 PCI-related inpatient encounters including 153,706 OSA, 65,135 OSA-COPD overlap, and 2,291 OSA+OHS patients

Comparison

OSA+OHS vs OSA-COPD overlap vs OSA alone

Design

Observational study using National Inpatient Sample (2007-2014)

Follow-up

In-hospital

Authors

RDRupak Desai SSSonali Sachdeva AJAkhil Jain

Discussion

Member takes

Overview

May warrant heightened periprocedural vigilance in OSA patients with COPD or obesity hypoventilation syndrome undergoing PCI; leaves open whether interventions modify outcomes.

Study Design

Type

Observational (n=4,792,177)

Multicenter

Yes

Structured PICO

Does the presence of concomitant COPD or obesity hypoventilation syndrome worsen clinical outcomes in patients with obstructive sleep apnea undergoing PCI?

Population

Exposure

Presence of concomitant obesity hypoventilation syndrome (OHS) or chronic obstructive pulmonary disease (COPD) in patients with OSA undergoing PCI

Comparator

Patients with OSA alone undergoing PCI

Outcome

Main Result

Odds Ratio: 1.21 (95% CI 1.11–1.32)

Absolute Event Rate: 1.5% vs 1.1%

p-value: p=<0.001

Limitations

Retrospective study based on administrative ICD-9 CM coding runs the risk of underreporting or overreporting
Only reports in-patient outcomes without long-term follow-up or functional outcomes
Lack of arterial blood gas, laboratory, medication, and echocardiographic data
Severity of OSA, OSA-COPD, and OHS was not known before PCI
Potential residual confounding due to retrospective nature and variation in hospital care
Lack of long-term outcomes

Cite This Study

synapsesocial.com/papers/6aace40ed0cf774bc88583f2 https://doi.org/10.7759/cureus.24816

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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