Positive Airway Pressure Adherence, Mortality, and Cardiovascular Events in Patients with Sleep Apnea

医学 危险系数 气道正压 四分位数 内科学 阻塞性睡眠呼吸暂停 置信区间 比例危险模型 睡眠呼吸暂停 冲程(发动机) 随机对照试验 临床试验 机械工程 工程类
作者
Chloé Gervès-Pinquié,Sébastien Bailly,F. Goupil,Thierry Pigeanne,Sandrine Launois,Laurène Leclair‐Visonneau,Philippe Masson,Acya Bizieux-Thaminy,Margaux Blanchard,AbdelKébir Sabil,Dany Jaffuel,Jean-Louis Racineux,Wojciech Trzépizur,Frédéric Gagnadoux
出处
期刊:American Journal of Respiratory and Critical Care Medicine [American Thoracic Society]
卷期号:206 (11): 1393-1404 被引量:30
标识
DOI:10.1164/rccm.202202-0366oc
摘要

Rationale: Randomized controlled trials showed no effect of positive airway pressure (PAP) therapy for obstructive sleep apnea (OSA) on cardiovascular (CV) risk. However, patient selection and low PAP adherence preclude the generalization of their data to clinical samples. Objectives: To evaluate the association between hours of PAP use, mortality, and CV morbidity in real-life conditions. Methods: Data from the Pays de la Loire Cohort were linked to health administrative data to identify incident major adverse cardiovascular events (MACEs; a composite outcome of mortality, stroke, and cardiac diseases) in patients with OSA who were prescribed PAP. Cox proportional hazards analyses were conducted to evaluate the association between MACEs and quartiles of average daily PAP use over the study period. Measurements and Main Results: After a median follow-up of 6.6 years, 961 of 5,138 patients experienced MACEs. Considering nonadherent patients (0–4 h/night) as the reference group, adjusted hazard ratios (95% confidence intervals) for MACEs were 0.87 (0.73–1.04) for the 4–6 h/night group, 0.75 (0.62–0.92) for the 6–7 h/night group, and 0.78 (0.65–0.93) for the ⩾7 h/night group (P = 0.0130). Sensitivity analyses using causal inference approaches confirmed the association of PAP use with MACEs. The association was stronger in male patients (P value for interaction = 0.0004), patients without overt CV disease at diagnosis (P < 0.0001), and those belonging to the excessively sleepy symptom subtype (P = 0.060). Conclusions: These real-life clinical data demonstrate a dose–response relationship between PAP adherence and incident MACEs in OSA. Patient support programs may help improve PAP adherence and CV outcomes in patients with OSA.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
yydragen应助飞云采纳,获得50
刚刚
勤奋盼晴发布了新的文献求助10
1秒前
3秒前
刺猬完成签到,获得积分10
3秒前
宋映梦完成签到 ,获得积分10
4秒前
慕青应助xiaoyuanbao1988采纳,获得10
4秒前
okk完成签到 ,获得积分10
4秒前
enchanted发布了新的文献求助10
4秒前
4秒前
5秒前
vin应助杜兰特采纳,获得20
5秒前
zhangh65完成签到,获得积分10
6秒前
香蕉觅云应助娟子苏采纳,获得10
6秒前
lins完成签到,获得积分10
8秒前
穆承羲完成签到 ,获得积分10
9秒前
hh完成签到,获得积分10
10秒前
11秒前
11秒前
可靠的访冬完成签到,获得积分10
11秒前
12秒前
张叮当发布了新的文献求助10
12秒前
听话的代芙完成签到 ,获得积分10
14秒前
14秒前
彭于晏应助许子健采纳,获得10
15秒前
Rita发布了新的文献求助20
16秒前
17秒前
英俊白莲发布了新的文献求助10
17秒前
清脆水卉发布了新的文献求助10
17秒前
拉圈最菜妮厨完成签到,获得积分10
18秒前
18秒前
博修发布了新的文献求助10
19秒前
lifezqh关注了科研通微信公众号
19秒前
20秒前
黄智清完成签到,获得积分10
20秒前
优秀的莹发布了新的文献求助10
21秒前
彩色的听芹完成签到,获得积分20
21秒前
娟子苏发布了新的文献求助10
22秒前
22秒前
科研通AI2S应助椰汁糕采纳,获得10
23秒前
23秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989645
求助须知:如何正确求助?哪些是违规求助? 3531805
关于积分的说明 11254983
捐赠科研通 3270372
什么是DOI,文献DOI怎么找? 1804966
邀请新用户注册赠送积分活动 882136
科研通“疑难数据库(出版商)”最低求助积分说明 809176