Effects of continuous positive airway pressure on clinical and angiographic follow-up outcomes in patients with acute myocardial infarction

Abstract

Aims: To examine the effects of Continuous Positive Airway Pressure (CPAP) on clinical and angiographic follow-up results in patients with acute myocardial infarction complicated by moderate to severe Obstructive Sleep Apnea (OSA). Methods: This study included 102 patients who underwent primary Percutaneous Coronary Intervention (PCI). All patients met the criteria of moderate to severe OSA defined as apnea–hypopnea index ≥ 20 events/h. Main outcome measures were cardiac death, recurrence of acute coronary syndrome (ACS), and readmission for heart failure. Major Adverse Cardiac Events (MACE) were defined as composite end points of individual clinical outcomes. Secondary outcome measures were target vessel revascularization and new PCI for progressive lesions. Results: The median follow-up duration was 1334 days. Sixty-three patients on CPAP exhibited lower rates of cardiac death, recurrence of ACS, and MACE than those not on CPAP (1.6% vs. 7.7%; 11.1% vs. 23.1%; 17.5% vs. 28.2%, respectively), but the differences were not statistically significant. Follow-up coronary angiography was completed in 98 patients. The rate of new PCI was significantly lower in the patients on CPAP (18.0%) than in those not on CPAP (37.8%, p = 0.029). Multivariate Cox regression adjusted for CPAP, diabetes, hypertension, smoking, and dyslipidemia showed that CPAP significantly decreased the rate of new PCI (hazard ratio, 0.37; 95% confidence interval, 0.14–0.96). ![Figure][1] Predictor of new PCI Conclusion: CPAP could not completely eliminate the occurrence of MACE but may prevent lesion progression. [1]: pending:yes