Treatment of obstructive sleep apnea is associated with decreased cardiac death after percutaneous coronary intervention

Objectives Our purpose was to compare outcomes of patients treated for obstructive sleep apnea (OSA) versus patients with untreated OSA, all of whom had undergone percutaneous coronary intervention (PCI). Background Obstructive sleep apnea has been associated with increases in fatal and nonfatal cardiovascular events. It is not known whether treatment of OSA in patients who have had PCI results in a better outcome. Methods In a retrospective cohort study, a group of patients with OSA diagnosed with polysomnography between 1992 and 2004 (apnea-hypopnea index >= 15) who subsequently underwent a PCI (n = 371) were stratified according to whether they were treated for OSA (n = 175) or not (n = 196). Main outcome measures were cardiac death, general mortality, major adverse cardiac events (MACE) (severe angina, myocardial infarction, PCI, coronary artery bypass grafting, or death), and major adverse cardiac or cerebrovascular events (MACCE). Results Patients treated for OSA had a statistically significant decreased number of cardiac deaths on follow-up when compared with untreated OSA patients (3% [95% confidence interval (CI) 0% to 6%] vs. 10% [95% Cl 5% to 14%] after 5 years, p = 0.027), as well as a trend toward decreased all-cause mortality (p = 0.058). There was no difference in the number of MACE or MACCE between the :2 groups (p = 0.91 and 0.96, respectively). Conclusions Treatment of OSA is associated with a reduction in the number of cardiac deaths, but not in MACE or MACCE, after PCI. Screening for and treating OSA in patients with coronary artery disease who may undergo PCI may result in decreased cardiac death.