Morbidity and mortality in patients with cardiovascular risk factors and obstructive sleep apnoea: results from the DIAST-CHF cohort

Respir Med. 2019 Jul-Aug:154:127-132. doi: 10.1016/j.rmed.2019.06.019. Epub 2019 Jun 21.

Abstract

Study objectives: Aim of the study was to investigate the association between obstructive sleep apnoea (OSA) and cardiovascular morbidity and mortality in a cohort of patients with cardiovascular risk factors.

Methods: In this prospective study, 378 patients of the DIAST-CHF cohort were screened for OSA by home polygraphy. Inclusion criteria were risk factors for diastolic heart failure, such as hypertension, diabetes mellitus, atherosclerotic disease, or history of chronic heart failure. Patients were followed up after 1, 2, 5, 9 and 10 years for the occurrence of major adverse cardiac and cerebrovascular events (MACE and MACCE).

Results: 344 patients were included in the analysis, of which 60% were diagnosed with OSA (apnoea-hypopnoea index ≥5/h). Overall mortality was higher in the OSA group (14.9% vs. 5.9%; p = 0.007), but significance disappeared after adjustment for age and sex (hazard ratio (HR) 1.89, 95% confidence interval (CI) 0.86-4.16, p = 0.12). There was no significant difference in the occurrence of MACE or MACCE in patients with OSA compared to those without OSA (MACE: 31% vs. 30%; p = 0.61; MACCE: 32% vs. 30%; p = 0.53).

Conclusion: We did not find evidence of an adverse effect of OSA on cardiovascular morbidity and mortality in a cohort of patients with cardiovascular risk factors.

Keywords: AHI; MACCE; MACE; OSA; Sleep disordered breathing; Sleep related breathing disorders.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atherosclerosis / epidemiology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Case-Control Studies
  • Chronic Disease
  • Cohort Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Germany / epidemiology
  • Heart Failure / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Morbidity / trends
  • Prospective Studies
  • Risk Factors
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / mortality*
  • Sleep Apnea, Obstructive / physiopathology*