Source: Annual Congress 2011 - Obstructive sleep apnoea in children and adults
Disease area: Sleep and breathing disorders

Abstract

OBJECTIVES: The RICCADSA study is a randomized, controlled trial started in 2005 addressing the impact of CPAP in revascularized coronary artery disease (CAD) patients and concomitant OSA (Apnoea-Hypopnoea-Index [AHI]≥15/h) without daytime sleepiness (Epworth Sleepiness Scale <10). The primary outcome is the combined rate of new revascularization, myocardial infarction, stroke and cardiovascular mortality over a mean period of 3 years. Among secondary outcomes, cardiac function is also evaluated. PARTICIPANTS AND METHODS: Among 660 screened CAD patients, 511 (399 OSA, 112 non-OSA) have been assessed by echocardiography and p-NT proBNP at baseline. RESULTS: Compared to non-OSA subjects, patients with OSA had thicker interventricular septum and left ventricular posterior wall, enlarged left atrium and more diastolic dysfunction. Left ventricular ejection fraction was similar (56.9 vs 58.3%; ns). P-NTproBNP values were higher in the OSA patients (484.4 vs 332.5 ng/L; p=0.040). Within the OSA group, none of the echocardiographic measures differed significantly between sleepy and non-sleepy OSA subjects. However, p-NT proBNP values were higher (578.9 vs 336.7 ng/L; p=0.002) in the non-sleepy OSA subjects. CONCLUSIONS: In this RICCADSA cohort, adverse alterations in cardiac structure as well as diastolic dysfunction were more common and p-NT-proBNP values increased in OSA patients compared to non-OSA patients. Whether the more elevated p-NT-proBNP values in the non sleepy subjects reflect a poorer prognosis and if CPAP is effective in OSA patients remain to be demonstrated when the trial is completed.

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Y. Peker, H. Glantz, E. Thunstrom, B. Cederin, J. Herlitz, J. Ejdeback (Skovde & Lidkoping, Gothenburg, Sweden). Late-breaking abstract: Cardiac function in a revascularized coronary artery disease cohort with obstructive sleep apnoea with and without daytime sleepiness in the RICCADSA trial. Eur Respir J 2011; 38: Suppl. 55, 3237

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