Cardiovascular Effects of Continuous Positive Airway Pressure Treatment in Patients With Obstructive Sleep Apnea: A Meta-Analysis.
Gamze AslanBaris AfsarDimitrie SiriopolMehmet KanbayOguzhan SalCaghan BenliJohn OkcuogluAdrian CovicMehmet KanbayPublished in: Angiology (2017)
Continuous positive airway pressure (CPAP) is the first-line treatment of obstructive sleep apnea (OSA). Obstructive sleep apnea is a predictor of cardiovascular (CV) events. In this meta-analysis, we evaluated the effect of CPAP on left ventricular ejection fraction (LVEF), CV events, CV mortality, and all-cause mortality in patients with OSA. Nine articles (n = 9610 patients) were analyzed. Four different meta-analyses were performed: evaluation of LVEF, assessment of all-cause mortality, CV mortality, and CV events. Continuous positive airway pressure treatment was associated with a significant increase in LVEF (mean difference: 2.1%, 95% confidence interval [CI]: 0.8%-3.4%). There was a nonsignificant reduction in all-cause mortality (hazard ratio [HR]: 0.92, 95% CI: 0.73-1.15) but a significant reduction of 66% in the risk of CV mortality associated with the CPAP treatment (HR: 0.34, 95% CI: 0.17-0.68, P = .002). There was a nonsignificant reduction in the risk of CV events in the CPAP-treated patients (HR: 0.84, 95% CI: 0.60-1.18, P = .31). Our meta-analyses showed that CPAP treatment improves LVEF and could have a beneficial effect on CV mortality.
Keyphrases
- obstructive sleep apnea
- positive airway pressure
- sleep apnea
- ejection fraction
- meta analyses
- systematic review
- left ventricular
- end stage renal disease
- aortic stenosis
- cardiovascular events
- risk factors
- heart failure
- randomized controlled trial
- combination therapy
- cardiovascular disease
- type diabetes
- prognostic factors
- aortic valve
- chronic kidney disease
- mitral valve
- hypertrophic cardiomyopathy
- replacement therapy