Document Detail

Influence of obstructive sleep apnea on mortality in patients with heart failure.
MedLine Citation:
PMID:  17433953     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study sought to determine, in patients with heart failure (HF), whether untreated moderate to severe obstructive sleep apnea (OSA) is associated with a higher mortality rate than in patients with mild to no sleep apnea (M-NSA). BACKGROUND: Obstructive sleep apnea is common in patients with HF and exposes the heart and circulation to adverse mechanical and autonomic effects. However, its effect on mortality rates of patients with HF has not been reported. METHODS: In a prospective study involving 164 HF patients with left ventricular ejection fractions (LVEFs) < or =45%, we performed polysomnography and compared death rates between those with M-NSA (apnea-hypopnea index [AHI] <15/h of sleep) and those with untreated OSA (AHI > or =15/h of sleep). RESULTS: During a mean (+/- SD) of 2.9 +/- 2.2 and a maximum of 7.3 years of follow-up, the death rate was significantly greater in the 37 untreated OSA patients than in the 113 M-NSA patients after controlling for confounding factors (8.7 vs. 4.2 deaths per 100 patient-years, p = 0.029). Although there were no deaths among the 14 patients whose OSA was treated by continuous positive airway pressure (CPAP), the mortality rate was not significantly different from the untreated OSA patients (p = 0.070). CONCLUSIONS: In patients with HF, untreated OSA is associated with an increased risk of death independently of confounding factors.
Hanqiao Wang; John D Parker; Gary E Newton; John S Floras; Susanna Mak; Kuo-Liang Chiu; Pimon Ruttanaumpawan; George Tomlinson; T Douglas Bradley
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-04-02
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  49     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-16     Completed Date:  2007-05-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1625-31     Citation Subset:  AIM; IM    
Sleep Research Laboratory of the Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
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MeSH Terms
Age Distribution
Analysis of Variance
Case-Control Studies
Cause of Death*
Continuous Positive Airway Pressure*
Heart Failure / diagnosis,  mortality*,  therapy
Middle Aged
Proportional Hazards Models
Prospective Studies
Reference Values
Risk Assessment
Severity of Illness Index
Sex Distribution
Sleep Apnea, Obstructive / diagnosis,  mortality*,  therapy*
Statistics, Nonparametric
Survival Analysis
Comment In:
J Am Coll Cardiol. 2007 Apr 17;49(15):1632-3   [PMID:  17433954 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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