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Original Research: Sleep Disorders |

Treatment of OSA Reduces the Risk of Repeat Revascularization After Percutaneous Coronary InterventionTreatment of OSA and Repeat Revascularization

Xiaofan Wu, MD; Shuzheng Lv, MD; Xiaohong Yu, MD; Linyin Yao, MD; Babak Mokhlesi, MD, FCCP; Yongxiang Wei, MD
Author and Funding Information

From the Department of Cardiology (Drs Wu and Lv) and Department of Otolaryngology (Drs Yao and Wei), Beijing Anzhen Hospital, Capital Medical University, Beijing, China; and Department of Medicine (Drs Yu and Mokhlesi), Section of Pulmonary and Critical Care, Sleep Disorders Center, University of Chicago, Chicago, IL.

CORRESPONDENCE TO: Yongxiang Wei, MD, Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Rd, Chaoyang District, Beijing, China 100029; e-mail: drwuxf@163.com


FUNDING/SUPPORT: This work was supported by the Program for New Century Excellent Talents in University from the Ministry of Education of China [NCET-11-0898], National Natural Science Foundation of China [81470492], the Capital Health Research and Development Fund of China [2011-2003-05], and National Institutes of Health [Grant R01 HL119161 to Dr Mokhlesi].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(3):708-718. doi:10.1378/chest.14-1634
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BACKGROUND:  The impact of OSA treatment with CPAP on percutaneous coronary intervention (PCI) outcomes remains largely unknown.

METHODS:  Between 2002 and 2012, we identified 390 patients with OSA who had undergone PCI. OSA was diagnosed through in-laboratory sleep studies and defined by an apnea-hypopnea index ≥ 5 events/h. The cohort was divided into three groups: (1) moderate-severe OSA successfully treated with CPAP (n = 128), (2) untreated moderate-severe OSA (n = 167), and (3) untreated mild OSA (n = 95). Main outcomes included repeat revascularization, major adverse cardiac events (MACEs) (ie, death, nonfatal myocardial infarction, repeat revascularization), and major adverse cardiac or cerebrovascular events (MACCEs). The median follow-up period was 4.8 years (interquartile range, 3.0-7.1).

RESULTS:  The untreated moderate-severe OSA group had a higher incidence of repeat revascularization than the treated moderate-severe OSA group (25.1% vs 14.1%, P = .019). There were no differences in mortality (P = .64), MACE (P = .33), and MACCE (P = .76) among the groups. In multivariate analysis adjusted for potential confounders, untreated moderate-severe OSA was associated with increased risk of repeat revascularization (hazard ratio, 2.13; 95% CI, 1.19-3.81; P = .011).

CONCLUSIONS:  Untreated moderate-severe OSA was independently associated with a significant increased risk of repeat revascularization after PCI. CPAP treatment reduced this risk.

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