Cardiovascular Events in Moderately to Severely Obese Obstructive Sleep Apnea Patients on Positive Airway Pressure Therapy.

6533b82cfe1ef96bd1290208

RESEARCH PRODUCT

Cardiovascular Events in Moderately to Severely Obese Obstructive Sleep Apnea Patients on Positive Airway Pressure Therapy.

Jean-louis Pepin Jean-christian Borel Renaud Tamisier Anna Maria Marotta Louis Marie Galerneau Maria R. Bonsignore

subject

Pulmonary and Respiratory Medicine Adult Male medicine.medical_treatment Myocardial Infarction macromolecular substances Comorbidity Settore MED/10 - Malattie Dell'Apparato Respiratorio 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Sleep and breathing Risk Factors Severity of illness Positive airway pressure medicine Myocardial Revascularization Humans Continuous positive airway pressure Myocardial infarction Angina Unstable Obesity Acute Coronary Syndrome Stroke Aged Sleep-disordered breathing · Longitudinal studies · Continuous positive airway pressure · Noninvasive ventilation · Prognosis Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry Arrhythmias Cardiac Middle Aged medicine.disease Obesity respiratory tract diseases Obstructive sleep apnea Stroke 030228 respiratory system Cardiovascular Diseases Anesthesia Female business

description

Background: 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. Purpose: To assess the effect of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) on the occurrence of cardiovascular events in obese OSA patients. Methods: 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 years by a single home care provider. Baseline clinical characteristics, blood chemistry, and respiratory and vascular function were assessed. Incident cardiovascular events were investigated by phone interviews. Results: A total of 103 patients (55 men, 48 women; age and body mass index [BMI] at diagnosis 54.1 ± 10.5 years and 40.3 ± 5.5, respectively [mean ± standard deviation]; CPAP: n = 75; NIV: n = 28) agreed to participate in the study. Grade I, II, and III obesity occurred in 17.5, 33.0, and 49.5% of the sample, respectively. In patients using PAP treatment (n = 69), the mean nightly use was 6.3 ± 2.4 h. Thirty-one patients stopped PAP treatment during follow-up. Three patients on NIV died. Nonfatal cardiovascular events (n = 27) occurred in 19 patients, who were older and showed higher number of comorbidities and triglyceride levels than patients without events. In the patients who interrupted treatment, the event rate was high and increased with the number of comorbidities, while BMI at baseline did not predict events. Conclusions: The study suggests that regular PAP treatment may be associated with protection against cardiovascular risk in obese OSA patients, especially in the presence of multiple comorbidities.

year	journal	country	edition	language
2016-07-11	Respiration; international review of thoracic diseases

10.1159/000454988 https://pubmed.ncbi.nlm.nih.gov/28081532