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Treatment of obstructive sleep apnea reduces the risk of repeat revascularization after percutaneous coronary intervention.
MedLine Citation:
PMID:  25412159     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract: Background:The impact of obstructive sleep apnea (OSA) treatment with continuous positive airway pressure (CPAP) on percutaneous coronary intervention (PCI) outcomes remains largely unknown. Methods:Between 2002 and 2012 we identified 390 patients with OSA who had undergone a PCI. OSA was diagnosed by in-laboratory sleep studies and defined by an apnea-hypopnea index (AHI) ≥5 events/h. The cohort was divided into 3 groups: 1) moderate-severe OSA successfully treated with CPAP (n=128); 2) untreated moderate-severe OSA (n=167); and 3) untreated mild OSA (n=95). Main outcomes included repeat revascularization, major adverse cardiac events (MACE) (i.e. death, nonfatal myocardial infarction and repeat revascularization), and major adverse cardiac or cerebrovascular events (MACCE). The median follow up was 4.8 years (interquartile range 3.0 to 7.1). Results:The untreated moderate-severe OSA group had a higher incidence of repeat revascularization than the treated moderate-severe OSA group (25.1% vs. 14.1%, P=0.019). There were no differences in mortality (P=0.64), MACE (P=0.33) and MACCE (P=0.76) amongst the 3 groups. In multivariate analysis adjusted for potential confounders untreated moderate-severe OSA was associated with increased risk of repeat revascularization (hazard ratio 2.13, 95% CI 1.19-3.81, P=0.011). Conclusion:Untreated moderate-severe OSA was independently associated with a significant increased risk of repeat revascularization after PCI. CPAP treatment reduced this risk.
Background: The impact of obstructive sleep apnea (OSA) treatment with continuous positive airway pressure (CPAP) on percutaneous coronary intervention (PCI) outcomes remains largely unknown.
Methods: Between 2002 and 2012 we identified 390 patients with OSA who had undergone a PCI. OSA was diagnosed by in-laboratory sleep studies and defined by an apnea-hypopnea index (AHI) ≥5 events/h. The cohort was divided into 3 groups: 1) moderate-severe OSA successfully treated with CPAP (n=128); 2) untreated moderate-severe OSA (n=167); and 3) untreated mild OSA (n=95). Main outcomes included repeat revascularization, major adverse cardiac events (MACE) (i.e. death, nonfatal myocardial infarction and repeat revascularization), and major adverse cardiac or cerebrovascular events (MACCE). The median follow up was 4.8 years (interquartile range 3.0 to 7.1).
Results: The untreated moderate-severe OSA group had a higher incidence of repeat revascularization than the treated moderate-severe OSA group (25.1% vs. 14.1%, P=0.019). There were no differences in mortality (P=0.64), MACE (P=0.33) and MACCE (P=0.76) amongst the 3 groups. In multivariate analysis adjusted for potential confounders untreated moderate-severe OSA was associated with increased risk of repeat revascularization (hazard ratio 2.13, 95% CI 1.19-3.81, P=0.011).
Conclusion: Untreated moderate-severe OSA was independently associated with a significant increased risk of repeat revascularization after PCI. CPAP treatment reduced this risk.
Authors:
Xiaofan Wu; Shuzheng Lv; Xiaohong Yu; Linyin Yao; Babak Mokhlesi; Yongxiang Wei
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-20
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-20     Completed Date:  -     Revised Date:  2014-11-21    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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