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Efficacy of continuous positive airway pressure treatment on 5‐year survival in patients with ischaemic stroke and obstructive sleep apnea: a randomized controlled trial |
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| Authors: | Olga Parra Ángeles Sánchez‐Armengol Francisco Capote Marc Bonnin Adrià Arboix Francisco Campos‐Rodríguez José Pérez‐Ronchel Joaquín Durán‐Cantolla Cristina Martínez‐Null Mónica de la Peña Maria Carmen Jiménez Fernando Masa Ignacio Casadon Maria Luz Alonso José L. Macarrón |
| Affiliation: | 1. Servicio de Neumología, Department of Pneumology, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Spain;2. Olga Parra, MD, Department of Pneumology, Hospital Universitari del Sagrat Cor, C/Viladomat 288, E‐08029 Barcelona, Spain. Tel.: +34‐93‐3221111;3. fax: +34‐93‐4948906;4. e‐mail:;5. Unidad de Trastornos Respiratorios del Sue?o, Unidad Médico Quirúrgica de Enfermedades Respiratorias, Hospitales Universitarios Virgen del Rocío, Seville, Spain;6. Enfermedades Cerebrovasculares, Servicio de Neurología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Spain;7. Servicio de Neumología, Hospital Universitario de Valme, Sevilla, Spain;8. Unidad de Sue?o, Departamento de Medicina, Hospital Txagorritxu, Universidad del País Vasco, Vitoria‐Gasteiz, Spain;9. Unidad de Sue?o, Servicio de Neumología, Sección de Neumología, Hospital General Yagüe, Burgos, Spain;10. Servicio de Neurología, Hospital Universitario Son Dureta, Palma de Mallorca, Spain;11. Servicio de Neurología, Hospital San Pedro de Alcántara, Cáceres, Spain |
| Abstract: | The main purpose of the present analysis is to assess the influence of introducing early nasal continuous positive airway pressure (nCPAP) treatment on cardiovascular recurrences and mortality in patients with a first‐ever ischaemic stroke and moderate–severe obstructive sleep apnea (OSA) with an apnea–hypopnea index (AHI) ≥20 events h?1 during a 5‐year follow‐up. Patients received conventional treatment for stroke and were assigned randomly to the nCPAP group (n = 71) or the control group (n = 69). Cardiovascular events and mortality were registered for all patients. Survival and cardiovascular event‐free survival analysis were performed after 5‐year follow‐up using the Kaplan–Meier test. Patients in the nCPAP group had significantly higher cardiovascular survival than the control group (100 versus 89.9%, log‐rank test 5.887; P = 0.015) However, and also despite a positive tendency, there were no significant differences in the cardiovascular event‐free survival at 68 months between the nCPAP and control groups (89.5 versus 75.4%, log‐rank test 3.565; P = 0.059). Early nCPAP therapy has a positive effect on long‐term survival in ischaemic stroke patients and moderate–severe OSA. |
| Keywords: | ischaemic stroke mortality nasal continuous positive airway pressure |