Impact of continuous positive airway pressure treatment in female patients with cardiovascular disease and sleep-disordered breathing

Abstract

Background: Recent studies have shown that sleep-disordered breathing (SDB) is an independent predictor of poor prognosis and continuous positive airway pressure (CPAP) treatment contributes to reduce the risk. However, the evidence for the effectiveness of CPAP for female patients with cardiovascular disease (CVD) and SDB is lacking. Therefore, we assessed whether CPAP treatment improves long-term cardiovascular outcomes in female patients with CVD and moderate to severe SDB. Methods: We investigated 1693 patients who underwent a polysomnography between November 2004 and July 2011, and enrolled consecutive 51 female patients with moderate to severe SDB (apnea-hypopnea index ≥15 per hour), who had been hospitalized due to CVD before the sleep study. They were divided into two groups; a CPAP-treated group (n=15; treated with CPAP) and an untreated SDB group (n=35; untreated with CPAP). The frequency of death and hospitalization due to cardiovascular events (acute coronary syndrome, heart failure, stroke, and arrhythmias) between the groups was analyzed using multivariate analysis. Results: The mean follow-up period was 31.1±26.0 months and 18 patients (35.3%) died or were re-hospitalized due to cardiovascular events. Kaplan-Meier survival curves indicated that event-free survival was significantly higher in the CPAP-treated group than in the untreated SDB group (Figure). Multivariate analysis showed that the risk for death and re-hospitalization due to cardiovascular events was significantly higher in the untreated SDB group than in the CPAP-treated group (hazard ratio, 5.02; 95% confidence interval, 1.13 to 36.7; p<0.05). ![Figure][1] Kaplan-Meier event-free survival curves Conclusions: CPAP treatment improves cardiovascular outcomes in female patients with CVD and moderate to severe SDB. [1]: pending:yes