This article is part of Pulmonology Advisor’s coverage of the CHEST Virtual 2020 meeting.
Patients with sleep apnea who received positive airway pressure (PAP) therapy did not exhibit reduced cardiovascular risk compared with patients who received usual care, according to research presented at the 2020 CHEST Annual Meeting held virtually October 18 to 21.
Researchers used Pubmed, EMBASE, and CENTRAL databases to identify randomized clinical trials that evaluated the treatment of sleep apnea with usual care plus PAP vs usual care alone and also reported cardiovascular outcomes. Cardiovascular outcomes of interest were cardiovascular mortality, myocardial infarction, stroke, hospitalization for heart failure, and hospitalization for unstable angina.
A total of 8521 patients were part of the 11 prospective randomized clinical trials that met the inclusion criteria. In the primary study outcomes, there was no significant difference between usual care plus PAP vs usual care alone for were cardiovascular mortality, myocardial infarction, stroke, hospitalization for heart failure, or hospitalization for unstable angina.
There was a decreased risk of major adverse cardiovascular events with good adherence to PAP vs no PAP. Specifically, patients with PAP adherence of more than 4 hours per day had a lower rate of major adverse cardiovascular events than the patients in the control group. However, only one-third of the patients had good compliance to therapy.
“Further investigation on the effects of PAP on cardiovascular outcomes should consider using surrogates of compliance to therapy such as severity of oxygen desaturation, autonomic abnormalities during sleep study, and others,” the study authors wrote.
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Herrera Y, Poon J, Ho KS, et al. Cardiovascular outcomes in patients with sleep apnea treated with positive airway pressure: meta-analysis of randomized controlled trials. Presented at: the CHEST Virtual Annual Meeting; October 18-21, 2020. Abstract 2350.