Cardiovascular Events in Patients with Newly Diagnosed OSA Treated with CPAP

A correlation exists between obstructive sleep apnea (OPA) and increased cardiovascular disease (CVD). A study that was published online as part of the ATS 2020 International Conference assessed the rate of new cardiovascular events among Medicare beneficiaries with and without preexisting CVD who received a new diagnosis of OSA and were being treated with continuous positive airway pressure (CPAP) therapy.

The researchers retrospectively assessed a 5% sample of Medicare claims data representing adults aged ≥65 years with a new OSA diagnosis who initiated CPAP between 2009 and 2013 and had continuous Medicare coverage for two years after initiating CPAP. CVD included ischemic heart disease and cardiovascular or peripheral procedures. The researchers added the number of months from the date of first PAP charge to the earliest of either new cardiovascular event date or the end of observation (24 months) to calculate the person-time at risk. They determined incidence rates by dividing new cardiovascular events by person-months and then converting this to 100 person-years.

A total of 4,289 eligible Medicare beneficiaries (mean age, 72 years; 90% were white; 55% were male) were identified; 38% (n=1,615) had preexisting CVD, while 62% (n=2,674) had did not. During the 24 months after initiating CPAP, patients without preexisting CVD had a 10% risk for a new cardiovascular event; patients with preexisting CVD had a 74% risk. The incidence rates for new cardiovascular events for patients without prior CVD versus those with preexisting CVD were 5.2 per 100 person-years versus 74.5 per 100 person-years.

“Among beneficiaries newly diagnosed with OSA who initiated CPAP, those without prior CVD history were less likely to experience subsequent adverse cardiovascular events relative to beneficiaries with preexisting CVD,” the researchers summarized.