Response to impact of obstructive sleep apnea on cardiovascular outcomes in patients treated with percutaneous coronary intervention: rationale and design of the sleep and stent study

Meta-Analysis of the Effect of Obstructive Sleep Apnea on Cardiovascular Events After Percutaneous Coronary Intervention

Increasing evidence proved that obstructive sleep apnea (OSA) is associated with a variety of diseases, especially cardiovascular diseases. This study systematically reviewed the existing publications to assess the influence of OSA on cardiovascular survival among patients who underwent percutaneous coronary intervention. Eleven eligible publications, including 3,008 participants, were finally evaluated. Eight studies conducted adjustment of risk ratio for potential cardiovascular risk factors, 5 studies defined OSA groups as AHI (apnea hypopnea index) ≥15/hour, whereas the remaining eligible studies used AHI ≥5/hour, AHI ≥10/hour, or AHI ≥30/hour as the criteria. According to the result from 5 studies that use AHI ≥15/hour as OSA group, the existence of OSA could, to some extent, increase the risk of cardiovascular events (risk ratio 1.59, 95% confidence interval 1.22 to 2.06). Meanwhile, hazard ratio was also observed in separate co-morbidities, such as cardiac death, all-cause mortality, stroke, target lesion revascularization, non-fatal myocardial infarction, hospitalization for heart failure, and recurrence of acute coronary syndrome, regardless if the estimates are varied among studies. In conclusion, OSA can independently increase the risk of cardiovascular events, even after adjustment for confounders. Sleep health should be given utmost importance due to its extensive influence on cardiovascular disorders.