This article is more than 5 years old. Information may no longer be current.
Patients with AF and sleep apnea at high risk for hospitalization
Click Here to Manage Email Alerts
WASHINGTON — Patients with atrial fibrillation who also have obstructive sleep apnea are more likely to be hospitalized than patients with atrial fibrillation who have no evidence of sleep apnea, according to new data from the ORBIT-AF registry.
However, researchers found, among those with AF and sleep apnea, treatment with continuous positive airway pressure (CPAP) may attenuate the rate of AF progression.
At the American College of Cardiology Scientific Sessions, Jonathan P. Piccini, MD, MHS, FACC, FHRS, from Duke University, presented new data from ORBIT-AF, a registry of US outpatients with AF, on whether patients with obstructive sleep apnea (n=1,841) have worse outcomes and/or accelerated AF compared with those without obstructive sleep apnea (n=8,291). The researchers also analyzed whether patients in the registry with obstructive sleep apnea had different outcomes based on treatment with CPAP.
Jonathan P. Piccini
Patients with obstructive sleep apnea were more likely to have hypertension, hyperlipidemia, diabetes and chronic obstructive pulmonary disease than those who did not (P<.0001 for all). They were also more likely to experience symptoms, including dyspnea at exertion (35% vs. 26%) and fatigue (32% vs. 25%), Piccini said.
Over 2 years of follow-up, patients with obstructive sleep apnea were more likely to be hospitalized for any cause compared with patients with no evidence of sleep apnea (adjusted HR=1.12; 95% CI, 1.03-1.22). However, Piccini said, it was “reassuring” that patients with obstructive sleep apnea did not experience increased risk for all-cause death, first CV death/MI/stroke/transient ischemic attack and first major bleeding event.
Among those with obstructive sleep apnea, patients not receiving CPAP therapy had a higher risk for AF progression compared with those on CPAP therapy (OR=0.66; 95% CI, 0.46-0.94). There were no differences between those groups in all-cause death, first CV death/MI/stroke/TIA, first major bleeding event and all-cause hospitalization, according to Piccini.
“Among patients with sleep apnea, CPAP treatment may attenuate the rate of AF progression, and this highlights the importance of ongoing studies investigating the use of CPAP to reduce AF burden and to delay AF progression,” Piccini concluded. – by Erik Swain
For more information:
Piccini JP. Joint Session of the Heart Rhythm Society and the American College of Cardiology: Year in Review. Presented at: American College of Cardiology Scientific Sessions; March 29-31, 2014; Washington, D.C.
Disclosure: The ORBIT-AF registry is funded by Janssen Scientific Affairs LLC, a Johnson & Johnson company. Piccini reports financial ties with ARCA Biopharma, Forest Laboratories, GE Healthcare, Johnson & Johnson, Medtronic, Resmed and Spectranetics.