- In patients with acute coronary syndrome (ACS) who have obstructive sleep apnea (OSA) but do not complain of sleepiness, continuous positive airway pressure (CPAP) yields no cardiovascular (CV) event reduction benefit.
- The apnea was also not associated with CV event risk in this study.
Why this matters
- These authors say that their findings help explain the “observed neutral effect” of using CPAP for OSA in the setting of secondary prevention.
- Event rates did not differ with CPAP vs usual care:
- 16% vs 17%.
- HR, 0.89 (95% CI, 0.68-1.17; P=.40).
- Annual event rate:
- With CPAP: 7.18 per 100 person-years.
- With usual care: 7.78 per 100 person-years.
- Relative risk: 0.92 (0.74-1.15; P=.47).
- Adherence to CPAP also made no difference.
- Multicenter, open-label, parallel-group, randomized controlled trial, 15 hospitals in Spain.
- 2551 initially enrolled patients (mean age, 60 years) were randomly allocated to CPAP or usual care.
- Funding: ResMed (Australia); the Spanish Respiratory Society; others.
- Patients with severe ACS or cardiogenic shock were not included.
- Included only nonsleepy patients with OSA.