Moderate obstructive sleep apnea and cardiovascular outcomes in older adults: a propensity score-matched multicenter study (CPAGE-MODE study).

Autor:	López-Padilla D; Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón., Terán-Tinedo J; Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón.; Universidad Complutense de Madrid, Madrid, Spain., Cerezo-Lajas A; Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain., García LR; Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Ojeda-Castillejo E; Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain., López-Martín S; Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Diaz-Cambriles T; Sleep Unit, Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Virseda SG; Sleep Unit, Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Melgar BA; Sleep Unit, Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Pizarro AC; Sleep Unit, Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Alcocer HL; Sleep Unit, Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Troncoso-Acevedo MF; Respiratory Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., García TG; Respiratory Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., Yeste PL; Respiratory Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., Cano-Pumarega I; Sleep Unit, Respiratory Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.; CIBERES., García-Sánchez A; Sleep Unit, Respiratory Department, Hospital Universitario Ramon y Cajal, Madrid, Spain., Arcos BA; Respiratory Department, Hospital Universitario Infanta Leonor, Madrid, Spain., García EZ; Respiratory Department, Hospital Universitario de la Princesa, Madrid, Spain., Rodríguez PL; Respiratory Department, Hospital Universitario de la Princesa, Madrid, Spain., Iturricastillo G; Respiratory Department, Hospital Universitario de la Princesa, Madrid, Spain., Lores Gutiérrez V; Respiratory Department, Hospital Universitario Infanta Sofía, Madrid, Spain., Alonso CR; Respiratory Department, Hospital Universitario Infanta Sofía, Madrid, Spain., Ortola MV; Respiratory Department, Hospital Universitario Infanta Sofía, Madrid, Spain., López-Riolobos C; Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain., García-Prieto F; Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain., Abad-Fernández A; Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain., Baena EM; Sleep Unit, Respiratory Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2022 Feb 01; Vol. 18 (2), pp. 553-561.
DOI:	10.5664/jcsm.9656
Abstrakt:	Study Objectives: Obstructive sleep apnea (OSA) has been associated with cardiovascular events (CVEs), although recent randomized controlled trials have not demonstrated that long-term continuous positive airway pressure (CPAP) prevents CVEs. Our objective was to determine the effect of CPAP on older adults with moderate OSA regarding CVE reduction. Methods: An observational and multicenter study of a cohort of older adults (> 70 years of age) diagnosed with moderate OSA (apnea-hypopnea index 15.0-29.9 events/h) was conducted. Two groups were formed: (1) CPAP treatment and (2) standard of care. The primary endpoint was CVE occurrence after OSA diagnosis. Association with CPAP treatment was assessed by propensity score matching and inverse weighting probability. Secondary endpoints were incidence of CVE separately and time to first CVE. Results: A total of 614 patients were included. After matching, 236 older adults (111 men, mean age 75.9 ± 4.7 years) with a follow-up of 47 months (interquartile range: 29.6-64.0 months) were considered for primary and secondary endpoint evaluations. Forty-one patients presented at least 1 CVE (17.4%): 20 were in the standard-of-care group (16.9%) and 21 were in the CPAP group (17.8%), with a relative risk of 1.05 (95% confidence interval [CI], 0.60-1.83; P = .43) for CPAP treatment. Inverse probability weighting of the initial 614 patients determined an adjusted relative risk of 1.24 (95% CI, 0.79-1.96; P = .35) for CPAP treatment. No statistical differences were found in secondary endpoint analyses. Conclusions: CPAP should not be prescribed to reduce CVE probability in older adults with moderate OSA. Citation: López-Padilla D, Terán-Tinedo J, Cerezo-Lajas A, et al. Moderate obstructive sleep apnea and cardiovascular outcomes in older adults: a propensity score-matched multicenter study (CPAGE-MODE study). J Clin Sleep Med . 2022;18(2):553-561. (© 2022 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
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