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CPAP for prevention of cardiovascular events in obstructive sleep apnea

R. Doug McEvoy;Nick A. Antic;Emma Heeley;Yuanming Luo;Qiong Ou;希龙 张;Olga Mediano;锐 陈;Luciano F. Drager;Zhihong Liu;Guofang Chen;Baoliang Du;Nigel McArdle;Sutapa Mukherjee;Manjari Tripathi;Laurent Billot;Qiang Li;Geraldo Lorenzi-Filho;Ferran Barbe;Susan Redline;Jiguang Wang;Hisatomi Arima;Bruce Neal;David P. White;Ron R. Grunstein;南山 钟;Craig S. Anderson

Flinders University;Monash University;Southern Adelaide Local Health Network;University of Sydney;Guangzhou Medical College;Guangdong Provincial People's Hospital;Nanjing Medical University;Hospital Universitario de Guadalajara;Soochow University;Universidade de São Paulo;Peking University;Xuzhou Central Hospital;Hejian Municipal People's Hospital;Sir Charles Gairdner Hospital;All India Institute of Medical Sciences;Biomedical Research Institute of Lleida;CIBER - Center for Biomedical Research Network;Harvard University;Shanghai Jiao Tong University;Royal Prince Alfred Hospital

发表时间:2016-9-8

期 刊:New England Journal of Medicine

语 言:English

U R L: http://www.scopus.com/inward/record.url?scp=84986576828&partnerID=8YFLogxK

摘要

BACKGROUND: Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. METHODS: After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group). The primary composite end point was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for unstable angina, heart failure, or transient ischemic attack. Secondary end points included other cardiovascular outcomes, health-related quality of life, snoring symptoms, daytime sleepiness, and mood. RESULTS: Most of the participants were men who had moderate-to-severe obstructive sleep apnea and minimal sleepiness. In the CPAP group, the mean duration of adherence to CPAP therapy was 3.3 hours per night, and the mean apnea-hypopnea index (the number of apnea or hypopnea events per hour of recording) decreased from 29.0 events per hour at baseline to 3.7 events per hour during follow-up. After a mean follow-up of 3.7 years, a primary end-point event had occurred in 229 participants in the CPAP group (17.0%) and in 207 participants in the usual-care group (15.4%) (hazard ratio with CPAP, 1.10; 95% confidence interval, 0.91 to 1.32; P = 0.34). No significant effect on any individual or other composite cardiovascular end point was observed. CPAP significantly reduced snoring and daytime sleepiness and improved health-related quality of life and mood. CONCLUSIONS: Therapy with CPAP plus usual care, as compared with usual care alone, did not prevent cardiovascular events in patients with moderate-to-severe obstructive sleep apnea and established cardiovascular disease.

相关科学

医学

被引量

期刊度量

Scopus度量

年份 CiteScore SJR SNIP
1996
1997
1998
1999 7.361 10.989
2000 8.367 10.43
2001 8.571 10.65
2002 9.315 11.39
2003 10.407 13.878
2004 11.349 13.963
2005 9.888 12.13
2006 10.173 11.886
2007 10.481 11.853
2008 11.386 11.487
2009 11.765 11.932
2010 13.149 11.382
2011 56 13.674 12.685
2012 60.2 13.984 13.287
2013 58 14.796 14.706
2014 57.3 16.259 13.935
2015 57.4 16.591 13.011
2016 61.1 18.009 12.685
2017 67.2 19.476 12.908
2018 73.1 19.524 13.73
2019 66.1 18.291 13.212
2020 78
2021

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