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OSA may predict serious adverse outcomes following stroke, IHD

Obstructive sleep apnea appears to be linked with an increased risk for stroke, ischemic heart disease, and all-cause mortality among patients following vascular events, according to study results.

“Our results suggest that [obstructive sleep apnea] should be considered as a potential treatment target that might improve outcome and survival following stroke or [ischemic heart disease],” Wuxiang Xie, MD, PhD, of Beijing Anzhen Hospital, and colleagues wrote.

The researchers conducted a systematic review in August 2014 and searched Medline and Embase for studies assessing the associations between OSA and the risk for stroke, IHD and death among patients who experienced a stroke or IHD.

The researchers identified 13 hospital-based cohort studies; six studies were stroke patients and the other seven included IHD patients.

Five studies (n = 860) reported the risk of stroke, six (n = 1,083) reported IHD risk, and 11 (n = 1,930) reported all-cause mortality.

OSA was linked with a risk for stroke in patients who had a stroke or IHD (RR = 1.94; 95% CI, 1.29-2.92). OSA was also determined to be a risk factor for IHD in patients who experienced a stroke or IHD (RR = 1.83; 95% CI, 1.15-2.93).

Out of 1,930 patients, 515 deaths occurred and OSA increased all-cause mortality in the patients (RR = 1.59; 95% CI, 1.33-1.89).

The researchers indicated there are possible ways to reduce the risks OSA plays in all-cause mortality in stroke and IHD patients, but more research is needed.

“Based on this systematic review and meta-analysis, OSA could be identified as a risk factor for recurrence and mortality following vascular events, and treatment of OSA by CPAP would significantly reduce the risk of adverse outcomes,” the researchers wrote. “However, few [randomized-controlled trials] evaluated the effect of CPAP on recurrence and mortality among cardiovascular patients.”

Disclosure: The researchers report no relevant financial disclosures.