Abstract 2699: Therapeutic Impact of Continuous Positive Airway Pressure on Long-term Outcomes in Heart Failure Patients with Obstructive Sleep Apnea
Background: Previous studies showed that obstructive sleep apnea (OSA) is common in patients with heart failure (HF) and associated with poor cardiovascular outcomes. However, therapeutic impact of continuous positive airway pressure (CPAP) on mortality and morbidity remains unclear among patients with HF.
Methods: In a prospective cohort study, we examined 111 HF patients who underwent sleep study, and compared all-cause death and HF hospitalization rates among patients without OSA, those with untreated OSA (apnea-hypopnea index ≥ 10 per hr of sleep), and those with OSA treated by CPAP.
Results: Patients were divided into without OSA (N=32), untreated OSA (N=53) and treated OSA (N=26). During a median follow-up of 21±9 months, there was no death in those with treated OSA, while there was no significant difference in total death rate between those without OSA and with untreated OSA (log-rank test P=0.558). However, there were 52 (28%) all-cause deaths plus HF hospitalizations during follow-up. The composite of all-cause death plus HF hospitalization rate was significantly higher in patients with untreated OSA than both those without OSA and with treated OSA (32.7 vs. 11.8 vs. 4.7 per 100 person-year, respectively) (Figure⇓). In addition, after adjusting for confounding factors using multivariate analysis, the untreated OSA was an independent predictor of all-cause death plus HF hospitalization (HR 2.90, 95%CI 1.17–7.16, P=0.021).
Conclusions: This study suggests that in patients with HF, untreated OSA is strongly associated with an increased risk of all-cause death or HF hospitalization. CPAP treatment for OSA patients has beneficial effects on long term outcomes.