Continuous Positive Airway Pressure Therapy and Long-Term Outcomes in Patients with Coronary Artery Disease and Obstructive Sleep Apnea:A Meta-Analysis of Randomized Trials  

作　　者：Ruifeng Guo Qian Guo Wen Hao Jingyao Fan Shaoping Nie Xiao Wang 

机构地区：[1]Center for Coronary Artery Disease,Division of Cardiology,Beijing Anzhen Hospital,Capital Medical University,2 Anzhen Road,Chaoyang District,Beijing 100029,China

出　　处：《Cardiovascular Innovations and Applications》2024年第1期78-87,共10页心血管创新与应用(英文)

基　　金：funded by grants from National Key R&D Program of China(2022YFC2505600);the Training Program for Outstanding Young Scholars in Beijing Anzhen Hospital,Capital Medical University(AZ2023-YQ-03).

摘　　要：Background:Obstructive sleep apnea(OSA)is highly common in patients with coronary artery disease(CAD)and it is a strong predictor of subsequent cardiovascular events.However,whether treatment with continuous positive airway pressure(CPAP)can decrease this risk remains controversial.Methods:PubMed,EMBASE,the Cochrane Library,and ClinicalTrials.gov were systematically searched to identify randomized clinical trials reporting cardiovascular events from database inception to February 12,2022.Results:Four trials with 3043 participants were included.The median follow-up duration ranged from 3 to 4.75 years.Compared with usual care alone,CPAP was not associated with decreased MACCE risk(RR 0.96,95%CI 0.77–1.21,P=0.75),and the results were consistent regardless of CPAP adherence(≥4 hours/night vs.<4 hours/night,RR 0.48,95%CI 0.20–1.16).Similarly,no significant differences were observed between groups in the risks of all-cause death(RR 0.81,95%CI 0.52–1.26),cardiovascular death(RR 0.70,95%CI 0.36–1.33),myocardial infarction(RR 1.08,95%CI 0.73–1.60),revascularization(RR 1.03,95%CI 0.77–1.38),and cerebrovascular events(RR 0.77,95%CI 0.23–2.61).Conclusion:Existing evidence does not support an association between CPAP treatment and decreased risk of recur-rent cardiovascular events in patients with CAD and OSA,regardless of adherence to CPAP.

关 键 词：continuous positive airway pressure obstructive sleep apnea coronary artery disease cardiovascular outcomes META-ANALYSIS 

分 类 号：R54[医药卫生—心血管疾病]