Treatment of obstructive sleep apnea in patients with coronary artery disease significantly reduced the risk of cardiovascular events compared to no treatment (24% vs 58%; HR 0.24; 95% CI 0.09-0.62).
Cohort (n=54)
Does treatment of obstructive sleep apnoea reduce cardiovascular events in patients with coronary artery disease?
Treatment of obstructive sleep apnoea in patients with coronary artery disease is associated with a significant reduction in long-term cardiovascular events.
Effect estimate: HR 0.24 (95% CI 0.09-0.62)
Absolute Event Rate: 24% vs 58%
p-value: p=<0.01
AIM: The aim of this long-term prospective study was to evaluate the effect of treating obstructive sleep apnoea (OSA) on the rate of cardiovascular events in coronary artery disease (CAD). METHODS AND RESULTS: We prospectively studied 54 patients (mean age 57.3 +/- 10.1 years) with both CAD (> or = 70% coronary artery stenosis) and OSA (apnoea-hypopnoea index > or = 15). In 25 patients, OSA was treated with continuous positive airway pressure (n=21) or upper airway surgery (n=4); the remaining 29 patients declined treatment for their OSA. The median follow-up was 86.5 +/- 39 months. The two groups were similar at baseline in age, body mass index, smoking history, hypertension, hypercholesterolaemia, diabetes mellitus, number of diseased vessels, left ventricular ejection fraction, and CAD therapy. Treatment of risk factors other than OSA was similar in the two groups. The endpoint (a composite of cardiovascular death, acute coronary syndrome, hospitalisation for heart failure, or need for coronary revascularisation) was reached in 6 (6/25, 24%) and 17 (17/29, 58%) patients with and without OSA treatment, respectively (P<0.01). OSA treatment significantly reduced the risk of occurrence of the composite endpoint (hazard ratio 0.24; 95% confidence interval, 0.09-0.62; p<0.01) and of each of its components. CONCLUSIONS: Our data indicate that the treatment of OSA in CAD patients is associated with a decrease in the occurrence of new cardiovascular events, and an increase in the time to such events.
Olivier Milleron (2004) conducted a cohort in Coronary artery disease and obstructive sleep apnoea (n=54). Obstructive sleep apnoea treatment (continuous positive airway pressure or upper airway surgery) vs. No OSA treatment (declined treatment) was evaluated on Composite of cardiovascular death, acute coronary syndrome, hospitalisation for heart failure, or need for coronary revascularisation (HR 0.24, 95% CI 0.09-0.62, p=<0.01). Treatment of obstructive sleep apnea in patients with coronary artery disease significantly reduced the risk of cardiovascular events compared to no treatment (24% vs 58%; HR 0.24; 95% CI 0.09-0.62).