title: Treatment of OSA reduces the risk of repeat revascularization after percutaneous coronary intervention.
abstract: BACKGROUND
  The impact of OSA treatment with CPAP on percutaneous coronary intervention (PCI) outcomes remains largely unknown.
  
  
  METHODS
  Between 2002 and 2012, we identified 390 patients with OSA who had undergone PCI. OSA was diagnosed through in-laboratory sleep studies and defined by an apnea-hypopnea index ≥ 5 events/h. The cohort was divided into three groups: (1) moderate-severe OSA successfully treated with CPAP (n = 128), (2) untreated moderate-severe OSA (n = 167), and (3) untreated mild OSA (n = 95). Main outcomes included repeat revascularization, major adverse cardiac events (MACEs) (ie, death, nonfatal myocardial infarction, repeat revascularization), and major adverse cardiac or cerebrovascular events (MACCEs). The median follow-up period was 4.8 years (interquartile range, 3.0-7.1).
  
  
  RESULTS
  The untreated moderate-severe OSA group had a higher incidence of repeat revascularization than the treated moderate-severe OSA group (25.1% vs 14.1%, P = .019). There were no differences in mortality (P = .64), MACE (P = .33), and MACCE (P = .76) among the groups. In multivariate analysis adjusted for potential confounders, untreated moderate-severe OSA was associated with increased risk of repeat revascularization (hazard ratio, 2.13; 95% CI, 1.19-3.81; P = .011).
  
  
  CONCLUSIONS
  Untreated moderate-severe OSA was independently associated with a significant increased risk of repeat revascularization after PCI. CPAP treatment reduced this risk.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaofan
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Shuzheng
authors.initials: S
authors.lastname: Lv
authors.affiliation: Department of Medicine, Section of Pulmonary and Critical Care, Sleep Disorders Center, University of Chicago, Chicago, IL.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Linyin
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Medicine, Section of Pulmonary and Critical Care, Sleep Disorders Center, University of Chicago, Chicago, IL.
authors.forename: Babak
authors.initials: B
authors.lastname: Mokhlesi
authors.affiliation: Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: drwuxf@163.com.
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Wei
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000517:prevention & control*; D045422:Continuous Positive Airway Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome