Sleep Disorders: Obstructive Sleep Apnea |

Effect of Continuous Positive Airway Pressure on Prothrombotic Markers in Obstructive Sleep Apnea and Hypopnea Syndrome Patients: A Meta-analysis FREE TO VIEW

Yan Zhang, MD; Xiaoli Su, PhD; Jun He, MD; Jun Cheng, MD; Li Huang, PhD; Yuanyuan Li, PhD; Cheng-ping Hu, PhD
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Xiangya Hospital, Changsha, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A554. doi:10.1016/j.chest.2016.02.579
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SESSION TITLE: Obstructive Sleep Apnea

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Saturday, April 16, 2016 at 01:00 PM - 02:00 PM

PURPOSE: To evaluate the efficacy of continuous positive airway pressure (CPAP) on prothrombotic markers in patients with obstructive sleep apnea (OSA).

METHODS: Two reviewers independently searched PubMed, Cochrane library, Embase before August 2015. Information on characteristics of subjects, study design, pre- and post-CPAP treatment of whole blood viscosity (WBV), fibrinogen and plasminogen activator inhibitor-1 (PAI-1) were extracted for analysis.

RESULTS: 20 datasets from 10 studies with 239 subjects pooled. Treatment duration was range from 1 day to 1 year. WBV standardized mean differences (SMD) ranged -1.289mPa/s to 0.202mPa/s, pooled mean difference (PMD) was -0.504mPa/s (LL -0.807 to UL -0.200, p<0.01). SMD in fibrinogen ranged from -1.602mg/dl to 0.308mg/dl; PMD was -0.035mg/dl (LL -0.180 to UL 0.249, p=0.752). PAI-1 SMD ranged from -1.426ng/ml to -1.221ng/ml. The PMD was -1.364ng/ml (LL -1.939 to UL -0.790, p<0.001).

CONCLUSIONS: CPAP treatment seems to improve coagulation anomalies for OSA patients (decrease WBV and PAI-1), which may be associated with decreased cardiovascular complications and mortality in OSA patients after CPAP treatment. It does not appear to affect fibrinogen level. Additional large-scale, long-term and well-designed RCT investigation is required.

CLINICAL IMPLICATIONS: The present meta-analysis seem to demonstrate that CPAP treatment might improve coagulation anomalies in patients with OSA, which may be associated with decreased cardiovascular complications and mortality in OSA patients after CPAP treatment.

DISCLOSURE: The following authors have nothing to disclose: Yan Zhang, Xiaoli Su, Jun He, Jun Cheng, Li Huang, Yuanyuan Li, Cheng-ping Hu

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