Effect of CPAP Treatment on Cardiovascular Outcomes

• Jordi de Batlle ^[1] ; Esther Gracia Lavedán ^[1] ; Joan Escarrabill ^[3] ; Anna García Altés ^[4] ; Elisenda Martinez Carbonell ^[4] ; Mario Henríquez Beltrán ^[1] ; Manuel Sánchez de la Torre ^[2] ; Ferran Barbé ^[1]
  1. [1] Hospital Universitario Arnau de Vilanova

     Hospital Universitario Arnau de Vilanova

     Lérida, España

     
  2. [2] Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias

     Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias

     Madrid, España

     
  3. [3] Chronic Care Program (Hospital Clínic) & Master Plan for Respiratory Diseases (Department of Health, Catalonia) & REDISSEC, Barcelona, Spain
  4. [4] Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 60, Nº. 10, 2024, págs. 627-633
• Idioma: inglés
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• Dialnet Métricas: 2 Citas
• Resumen

  • Introduction Randomized controlled trials (RCT) have not demonstrated a role for continuous positive airway pressure (CPAP) on the secondary prevention of major cardiovascular events in obstructive sleep apnea (OSA) patients. However, participants in RCTs are substantially different from real-world patients. Therefore, we aimed to assess the effect of CPAP treatment on major cardiovascular events in real-world OSA patients.

    Methods Population-based longitudinal observational study including all OSA patients with an active CPAP prescription at the beginning of 2011 in Catalonia, Spain, that terminated CPAP treatment during 2011 and did not have CPAP prescriptions between 2012-2015; and propensity-score-matched OSA patients that continued CPAP treatment until the end of 2015 or death. Adjusted hazard ratios were used to assess the association between CPAP treatment and overall and cardiovascular mortality, cardiovascular hospitalizations, or major adverse cardiovascular events (MACEs).

    Results 3638 CPAP terminators and 10,914 propensity-score-matched continuators were included (median age 67 [57–77] years, 71.4% male). During a median follow-up of 47.9 months CPAP continuators showed a lower risk of cardiovascular death than terminators (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.50–0.75) after adjusting by age, sex and key comorbidities. Similar results were found for cardiovascular hospitalizations (HR: 0.87; 95% CI: 0.76–0.99) and MACEs (HR: 0.84; 95% CI: 0.75–0.95).

    Conclusion CPAP treatment continuation could be associated with a significantly lower risk of major cardiovascular events in real-world OSA patients. This result highlights the importance of including real-world patients in studies on OSA.