CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea
| Autor: | McEvoy, RD, Antic, NA, Heeley, E, Luo, Y, Ou, Q, Zhang, X, Mediano, O, Chen, R, Drager, LF, Liu, Z, Chen, G, Du, B, McArdle, N, Mukherjee, S, Tripathi, M, Billot, L, Li, Q, Lorenzi-Filho, G, Barbe, F, Redline, S, Wang, J, Arima, H, Neal, B, White, DP, Grunstein, RR, Zhong, N, Anderson, CS, SAVE Investigators and Coordinators |
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| Přispěvatelé: | SAVE Investigators and Coordinators |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Heart Health Coronary Artery Disease 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine General & Internal Medicine medicine Humans Myocardial infarction Continuous positive airway pressure Stroke Aged Sleep Apnea Obstructive SAVE Investigators and Coordinators Continuous Positive Airway Pressure business.industry Unstable angina Sleep apnea General Medicine 11 Medical And Health Sciences Middle Aged medicine.disease nervous system diseases respiratory tract diseases Intention to Treat Analysis Obstructive sleep apnea Hospitalization Cerebrovascular Disorders Treatment Outcome Cardiovascular Diseases Heart failure Cardiology Female business 030217 neurology & neurosurgery |
| Zdroj: | Recercat. Dipósit de la Recerca de Catalunya instname Repositorio Abierto de la UdL Universitad de Lleida |
| Popis: | Background Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. Methods After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group). The primary composite end point was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for unstable angina, heart failure, or transient ischemic attack. Secondary end points included other cardiovascular outcomes, health-related quality of life, snoring symptoms, daytime sleepiness, and mood. Results Most of the participants were men who had moderate-to-severe obstructive sleep apnea and minimal sleepiness. In the CPAP group, the mean duration of adherence to CPAP therapy was 3.3 hours per night, and the mean apnea–hypopnea index (the number of apnea or hypopnea events per hour of recording) decreased from 29.0 events per hour at baseline to 3.7 events per hour during follow-up. After a mean follow-up of 3.7 years, a primary end-point event had occurred in 229 participants in the CPAP group (17.0%) and in 207 participants in the usual-care group (15.4%) (hazard ratio with CPAP, 1.10; 95% confidence interval, 0.91 to 1.32; P=0.34). No significant effect on any individual or other composite cardiovascular end point was observed. CPAP significantly reduced snoring and daytime sleepiness and improved health-related quality of life and mood. Conclusions Therapy with CPAP plus usual care, as compared with usual care alone, did not prevent cardiovascular events in patients with moderate-to-severe obstructive sleep apnea and established cardiovascular disease. Funded by the National Health and Medical Research Council of Australia and others; SAVE ClinicalTrials.gov number, NCT00738179; Australian New Zealand Clinical Trials Registry number, ACTRN12608000409370. |
| Databáze: | OpenAIRE |
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