A meta-analysis of continuous positive airway pressure therapy in prevention of cardiovascular events in patients with obstructive sleep apnoea
Pooled resultResult — go to the resultRelative risk 0.74 95% CI 0.47–1.17Authors' conclusion
CPAP therapy might reduce MACE and stroke among subjects with CPAP time exceeding 4 h/night.
Study context
- Population
- Patients with moderate-to-severe obstructive sleep apnoea (OSA)
- Participants
- 4,268 patients · 7 randomized controlled trials (RCTs)
- Comparison
- Continuous positive airway pressure (CPAP) vs no CPAP
- Outcome
- MACE
Methodological detailsSearched MEDLINE, EMBASE and Cochrane library (inception–December 2016); 235 articles recovered
- Searched MEDLINE, EMBASE and Cochrane library (inception–December 2016); 235 articles recovered
Pooled result
As reported in the abstract
Relative risk
0.74
95% CI 0.47–1.17
P = 0.19
CPAP vs NO CPAP
RR 0.74 (95% CI 0.47–1.17); P = 0.19
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| MACE with CPAP adherence ≥4 h/night (subgroup)I2 = 0% | 0.43 (0.23–0.80) | P = 0.01 | |
| 0.20.5125Relative risk (log scale) |
| Outcome | MD (95% CI) | P value |
|---|---|---|
| Daytime sleepiness (ESS)I2 = 81% | −2.50 (- 3.62, −1.39) | P < 0.001 |
Major adverse cardiovascular events (MACE) and stroke, by CPAP usage time (sensitivity analyses)
- Increased CPAP usage time yielded significant risk reduction in MACE and stroke
Myocardial infarction (MI), all-cause mortality, atrial fibrillation/flutter (AF), heart failure (HF)
- No beneficial effect on MI, all-cause mortality, AF/flutter or HF
- P > 0.05
Daytime sleepiness (Epworth Sleepiness Scale (ESS))
- Positive effect on mood
Original publication
A meta-analysis of continuous positive airway pressure therapy in prevention of cardiovascular events in patients with obstructive sleep apnoea. Eur Heart J. Published 24 October 2017. doi:10.
Summarised from the published abstract; every number is checked against it