Tag: obstructive sleep apnea

Continuous Positive Airway Pressure Therapy and Long-Term Outcomes in Patients with Coronary Artery Disease and Obstructive Sleep Apnea: A Meta-Analysis of Randomized Trials

Announcing a new article publication for Cardiovascular Innovations and Applications journal.

Obstructive sleep apnea (OSA) is highly common in patients with coronary artery disease (CAD) and it is a strong predictor of subsequent cardiovascular events. However, whether treatment with continuous positive airway pressure (CPAP) can decrease this risk remains controversial.

PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify randomized clinical trials reporting cardiovascular events from database inception to February 12, 2022.

Four trials with 3043 participants were included. The median follow-up duration ranged from 3 to 4.75 years. Compared with usual care alone, CPAP was not associated with decreased MACCE risk (RR 0.96, 95% CI 0.77–1.21, P = 0.75), and the results were consistent regardless of CPAP adherence (≥4 hours/night vs. <4 hours/night, RR 0.48, 95% CI 0.20–1.16). Similarly, no significant differences were observed between groups in the risks of all-cause death (RR 0.81, 95% CI 0.52–1.26), cardiovascular death (RR 0.70, 95% CI 0.36–1.33), myocardial infarction (RR 1.08, 95% CI 0.73–1.60), revascularization (RR 1.03, 95% CI 0.77–1.38), and cerebrovascular events (RR 0.77, 95% CI 0.23–2.61).

Existing evidence does not support an association between CPAP treatment and decreased risk of recurrent cardiovascular events in patients with CAD and OSA, regardless of adherence to CPAP.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0086

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Ruifeng Guo, Qian Guo and Wen Hao et al. Continuous Positive Airway Pressure Therapy and Long-Term Outcomes in Patients with Coronary Artery Disease and Obstructive Sleep Apnea: A Meta-Analysis of Randomized Trials. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2023.0086

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Renal Denervation: Past, Present, and Future

Renal Denervation: Past, Present, and Future

Authors: Pourafshar, Negiin; Karimi, Ashkan; Anderson, R. David; Alaei-Andabili, Seyed Hossein; Kandzari, David E.

Over the past decade, percutaneous renal denervation has been vigorously investigated as a treatment for resistant hypertension. The SYMPLICITY radiofrequency catheter system (Medtronic CardioVascular Inc., Santa Rosa, CA, USA) is the most tested device in clinical trials. After the positive results of small phase I and II clinical trials, SYMPLICITY HTN-3 (a phase III, multi-center, blinded, sham-controlled randomized clinical trial) was completed in 2014, but did not show significant blood pressure lowering effect with renal denervation compared to medical therapy and caused the investigators and industry to revisit both the basic science elements of renal denervation as well as the design of related clinical trials. This review summarizes the SYMPLICITY trials, analyzes the SYMPLICITY HTN-3 data, and provides insights gained from this trial in the design of the most recent clinical trial, the SPYRAL HTN Global clinical trial. Other than hypertension, the role of renal denervation in the management of other disease processes such as systolic and diastolic heart failure, metabolic syndrome, arrhythmia, and obstructive sleep apnea with the common pathophysiologic pathway of sympathetic overactivity is also discussed.

DOI: http://dx.doi.org/10.15212/CVIA.2016.0016

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