Moderate obstructive sleep apnea and cardiovascular outcomes in older adults: a propensity score-matched multicenter study (CPAGE-MODE study)

Obstructive sleep apnea (OSA) has been associated with cardiovascular events (CVEs), although recent randomized controlled trials have not demonstrated that long-term continuous positive airway pressure (CPAP) prevents CVEs. Our objective was to determine the effect of CPAP on older adults with mode...

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Bibliographic Details
Published in:	Journal of clinical sleep medicine Vol. 18; no. 2; pp. 553 - 561
Main Authors:	López-Padilla, Daniel, Terán-Tinedo, José, Cerezo-Lajas, Alicia, García, Laura Ramírez, Ojeda-Castillejo, Elena, López-Martín, Soledad, Diaz-Cambriles, Trinidad, Virseda, Sonia González, Melgar, Begoña Arias, Pizarro, Ana Candel, Alcocer, Héctor Lozano, Troncoso-Acevedo, María Fernanda, García, Teresa Gómez, Yeste, Pablo López, Cano-Pumarega, Irene, García-Sánchez, Aldara, Arcos, Beatriz Arias, García, Enrique Zamora, Rodríguez, Pedro Landete, Iturricastillo, Gorane, Lores Gutiérrez, Vanesa, Alonso, Carlos Rodríguez, Ortola, Martha Vidal, López-Riolobos, Cristina, García-Prieto, Fernando, Abad-Fernández, Araceli, Baena, Eva Mañas
Format:	Journal Article
Language:	English
Published:	United States American Academy of Sleep Medicine 01-02-2022
Subjects:	Aged Aged, 80 and over Cohort Studies Continuous Positive Airway Pressure Heart Humans Male Propensity Score Scientific Investigations Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - epidemiology Sleep Apnea, Obstructive - therapy obstructive sleep apnea cardiovascular epidemiology geriatric medicine
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Summary:	Obstructive sleep apnea (OSA) has been associated with cardiovascular events (CVEs), although recent randomized controlled trials have not demonstrated that long-term continuous positive airway pressure (CPAP) prevents CVEs. Our objective was to determine the effect of CPAP on older adults with moderate OSA regarding CVE reduction. An observational and multicenter study of a cohort of older adults (> 70 years of age) diagnosed with moderate OSA (apnea-hypopnea index 15.0-29.9 events/h) was conducted. Two groups were formed: (1) CPAP treatment and (2) standard of care. The primary endpoint was CVE occurrence after OSA diagnosis. Association with CPAP treatment was assessed by propensity score matching and inverse weighting probability. Secondary endpoints were incidence of CVE separately and time to first CVE. A total of 614 patients were included. After matching, 236 older adults (111 men, mean age 75.9 ± 4.7 years) with a follow-up of 47 months (interquartile range: 29.6-64.0 months) were considered for primary and secondary endpoint evaluations. Forty-one patients presented at least 1 CVE (17.4%): 20 were in the standard-of-care group (16.9%) and 21 were in the CPAP group (17.8%), with a relative risk of 1.05 (95% confidence interval [CI], 0.60-1.83; = .43) for CPAP treatment. Inverse probability weighting of the initial 614 patients determined an adjusted relative risk of 1.24 (95% CI, 0.79-1.96; = .35) for CPAP treatment. No statistical differences were found in secondary endpoint analyses. CPAP should not be prescribed to reduce CVE probability in older adults with moderate OSA. López-Padilla D, Terán-Tinedo J, Cerezo-Lajas A, et al. Moderate obstructive sleep apnea and cardiovascular outcomes in older adults: a propensity score-matched multicenter study (CPAGE-MODE study). . 2022;18(2):553-561.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1550-9389 1550-9397 1550-9397
DOI:	10.5664/jcsm.9656