RT Journal Article
SR Electronic
T1 Evaluation of cardiovascular risk after long-term c-PAP therapy in patients with obstructive sleep apnea. A 4-year follow-up
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA4785
DO 10.1183/13993003.congress-2015.OA4785
VO 46
IS suppl 59
A1 Carratù, Pierluigi
A1 Zito, Annapaola
A1 Quaranta, Vitaliano
A1 Carbonara, Rossella
A1 Devito, Fiorella
A1 Resta, Onofrio
A1 Ciccone, Marco
YR 2015
UL https://publications.ersnet.org//content/46/suppl_59/OA4785.abstract
AB Aimof the study: was to investigate in OSA patients the change of Intima-Media Thickness (IMT) during a follow-up period of 51 months, according to the c-PAP adherence, and the role of c-PAP on Flow Mediated Dilation (FMD) and cardiovascular risk.Methods: This longitudinal study includes two times: “T0” and “T1”. At “T0”, 156 OSA patients (125 M) started c-PAP treatment. At “T1” the study was completed only by 99 patients (78 M), because 57 subjects dropped out the study. At “T1” 30 patients had never used c-PAP, while 69 of them were in optimal c-PAP adherence (>4 hrs/night). At “T0” and “T1” we evaluated anthropometric factors, lenght of c-PAP treatment, c-PAP adherence, and IMT. At “T1”we measured FMD, IMT and Δ-IMT (change in the carotid IMT between T1 and T0, ΔIMT= IMTT1-IMTT0). We defined “negative Δ-IMT” if IMTT1-IMTT0 <0 mm and positive Δ-IMT if IMTT1-IMTT0 ≥0mm.Results: Patients, who were adherent to c-PAP, had a lower daytime sleepiness, lower PaCO2, and lower IMT (p<0.005). The FMD was higher than FMD of not adherents (p <0.05). The subgroup of negative Δ-IMT used c-PAP for a higher number of hours, compared to those with positive Δ-IMT (p = 0.005). Patients with ΔIMT <0 at “T1” showed lower PaCO2 (p = 0.016). The univariate COX analysis shows, as only significant protective factor for new cardiovascular events, the lenght of c-PAP use (p = 0.045). In the multivariate binomial logistic regression model, considering ΔIMT as the dependent variable, the only significant predictive value was adherence to c-PAP (OR 1.118, p=0.039).Conclusions: this study demonstrates that adherence to c-PAP improves endothelial function and IMT over time.