Abstract 10744: Efficacy of Remote Pulmonary Artery Hemodynamic Monitoring in Reducing Heart Failure Readmissions Among Patients with Obstructive Sleep Apnea of Varying Severity

Abstract

Introduction: Obstructive sleep apnea (OSA) and heart failure (HF) often co-exist. Remote pulmonary artery (PA) hemodynamic monitoring has shown to decrease HF readmissions. However, there is limited data regarding its efficacy in patients with OSA of varying severity. Hypothesis: Outcomes of remote PA hemodynamic monitoring using CardioMEMS device in reducing HF hospitalization in patients with mild [apnea-hypopnea index (AHI)=5-14], moderate (AHI=15-30) and severe OSA (AHI>30). Methods: Retrospective data was collected for HF patients who had CardioMEMS device implanted based on FDA indications from April 2015 to August 2020. Number of hospitalizations, emergency department (ED) and HF clinic visits data was collected for 1-year pre and 1-year post-implantation. Mortality data was collected at 1-year post-implantation. Severity of OSA was based on AHI documented in the sleep study. Analysis was done using Kruskal-Wallis test for comparison between OSA groups. Mortality was compared with Pearson’s chi-squared test. Results: CardioMEMS device was implanted in 177 patients during the study period. Of this, 108(61%) patients had OSA diagnosed at the time of implantation. Among OSA patients, 52(48%) had severe OSA. There was a statistically significant decrease in overall mean HF admissions from 1.80(± 1.55) to 0.62(± 1.07), 65.6%, p<0.001 and mean HF ED visits from 1.37(± 1.50) to 0.5(± 0.95), 63.5%, p<0.001 in 1-year pre-and post-implantation among all OSA patients. When comparing different OSA groups, there was no statistically significant difference between them in all-cause admissions, HF admissions, ED visits, ED HF visits, and HF clinic visits 1-year pre and post-implantation. No statistically significant difference was observed in mortality. Conclusions: PA hemodynamic monitoring using CardioMEMS device had a net benefit in reducing HF admissions and HF ED visits in OSA patients and this benefit remained unchanged across different OSA groups.