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RESEARCH PRODUCT

Incident cardiovascular events in severely obese patients treated with continous positive airway pressure (CPAP)/non invasive ventilation (NIV): A 5.5-year follow-up

subject

description

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 baseline underwent: clinical examination, respiratory function assessment, full PSG, vascular function (PWV, PAT). Mean (±SD) age and BMI at diagnosis were 53.6±10.7 yr and 40.6±5.7 kg/m 2 . Patients were affected by OSA (n=100) or OHS (n=17); CPAP (n=89) or NIV (n=28) were prescribed. At follow-up, 32 OSA patients had stopped treatment, 57 were on CPAP, and 28 on NIV. Objective compliance to treatment was similar in patients with/without events in both CPAP and NIV groups (mean adherence 6.3 ± 2.4 h/night). Number of events (0-2) was entered as dependent variable in a Poisson regression model in which independent variables were treatment (CPAP or NIV vs interrupted), follow-up duration, and BMI. CPAP showed a protective effect (coefficient: -4.75, p=0.02). Vascular function measurements did not predict events. Thus, CPAP treatment reduced the risk of CV events in severely obese OSA patients. Funded by ERS STRTF 4008-2013.