title: Efficacy of continuous positive airway pressure treatment on 5-year survival in patients with ischaemic stroke and obstructive sleep apnea: a randomized controlled trial.
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.
authors.affiliation: Servicio de Neumología, Department of Pneumology, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Parra
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Sánchez-Armengol
authors.forename: Francisco
authors.initials: F
authors.lastname: Capote
authors.forename: Marc
authors.initials: M
authors.lastname: Bonnin
authors.forename: Adrià
authors.initials: A
authors.lastname: Arboix
authors.forename: Francisco
authors.initials: F
authors.lastname: Campos-Rodríguez
authors.forename: José
authors.initials: J
authors.lastname: Pérez-Ronchel
authors.forename: Joaquín
authors.initials: J
authors.lastname: Durán-Cantolla
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez-Null
authors.forename: Mónica
authors.initials: M
authors.lastname: de la Peña
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Jiménez
authors.forename: Fernando
authors.initials: F
authors.lastname: Masa
authors.forename: Ignacio
authors.initials: I
authors.lastname: Casadon
authors.forename: Maria Luz
authors.initials: ML
authors.lastname: Alonso
authors.forename: José L
authors.initials: JL
authors.lastname: Macarrón
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000401:mortality*; D045422:Continuous Positive Airway Pressure; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D055502:Secondary Prevention; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D020521:Stroke / Q000150:complications* / Q000401:mortality*; D013997:Time Factors
keywords: ischaemic stroke; mortality; nasal continuous positive airway pressure