0000000000630236
AUTHOR
Renaud Tamisier
Application of Inverse-Probability-of-Treatment Weighting to Estimate the Effect of Daytime Sleepiness in Obstructive sleep apnea patients
Continuous positive airway pressure (CPAP), the first line therapy for obstructive sleep apnea (OSA), is considered effective in reducing daytime sleepiness. Its efficacy relies on adequate adherence, often defined as >4 hours per night. However, this binary threshold may limit our understanding of the causal effect of CPAP adherence and daytime sleepiness and multilevel approach for CPAP adherence can be more appropriate.
Arterial stiffness in obese CPAP-treated obstructive sleep apnea (OSA): A seven years prospective longitudinal study
Introduction: Arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) is elevated in severe OSA. A 1m/s increase in PWV is associated with a 15% increased risk of mortality. There is a paucity of data regarding long term evolution of PWV in CPAP-treated OSA. Aims: To measure PWV evolution in CPAP-treated OSA. Methods: In a prospective obese OSA cohort, we collected PWV, clinical and biological metabolic data, incident cardiovascular events and CPAP adherence at time of diagnosis and after at least 5-year follow-up. Results: 72 OSA (men: 52.8%, median age: 55.8 years and median BMI of 38.5 kg/m2) with a high prevalence of hypertension: 58.3%, Type 2 diabetes: 20.8%, hypercho…
ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19
The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing como…
Cardiovascular Events in Moderately to Severely Obese Obstructive Sleep Apnea Patients on Positive Airway Pressure Therapy.
<b><i>Background:</i></b> In moderately to severely obese patients with obstructive sleep apnea (OSA), the effects of long-term positive airway pressure (PAP) treatment on cardiovascular risk are poorly defined. <b><i>Purpose:</i></b> To assess the effect of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) on the occurrence of cardiovascular events in obese OSA patients. <b><i>Methods:</i></b> We performed a noninterventional observational study in obese OSA patients recruited between 2007 and 2010 at the Sleep Center, University of Grenoble, treated with CPAP or NIV, and followed for 5.6 year…
Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure
BackgroundObstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients. We aimed to prospectively study long term PWV variations and determinants of PWV deterioration.MethodsIn a prospective obese OSA cohort, at time of diagnosis and after several years of follow-up we collected arterial stiffness measured by carotid-femoral pulse wave velocity (PWV), clinical and metabolic parameters, and CPAP adheren…
Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19
Abstract Background We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admiss…
Fixed But Not Autoadjusting Positive Airway Pressure Attenuates the Time-dependent Decline in Glomerular Filtration Rate in Patients With OSA
Abstract: BACKGROUND: The impact of treating OSA on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different CPAP modalities. The aim of this study was to evaluate the respective influence of fixed and autoadjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database cohort. METHODS: In patients of the European Sleep Apnea Database, eGFR prior to and after follow-up was calculated by using the Chronic Kidney Disease-Epidemiology Collaboration equation. Three study groups were investigated: untreated patients (n = 14…
Incident cardiovascular events in severely obese patients treated with continous positive airway pressure (CPAP)/non invasive ventilation (NIV): A 5.5-year follow-up
it is still debated whether CPAP or non-invasive ventilation (NIV) reduces cardiovascular (CV) risk in morbidly obese patients. Obese subjects affected by obstructive sleep apnea (OSA) or obesity hypoventilation syndrome (OHS) (n=210) were recruited between 2007-2010 in the Sleep Center, Univ. of Grenoble; 152 of them were treated with CPAP or NIV, and regularly followed by a home-care provider (Agir a dom). Patients underwent phone interviews to assess incident CV events during 5.6 years (range 4.0-6.5 yrs) of follow-up. One hundred seventeen patients (63 men) responded to questionnaire, 3 OSA patients died, and 32 declined/were lost to follow-up (response rate 77%). All patients at baseli…