{"id":"2d34ad5f225e","type":"article","url":"https://hartvaat.nl/2018/06/21/cpap-en-cardiovasculaire-events-bij-obstructieve-slaapapneu-meta-analyse/","title":"CPAP en cardiovasculaire events bij obstructieve slaapapneu: meta-analyse","title_en":"A meta-analysis of continuous positive airway pressure therapy in prevention of cardiovascular events in patients with obstructive sleep apnoea.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","bradycardie","slaapapneu"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehx597","source_url":"https://doi.org/10.1093/eurheartj/ehx597","authors":["Safi U Khan","Crystal A Duran","Hammad Rahman","Manidhar Lekkala","Muhammad A Saleem","Edo Kaluski"],"significance":7,"published":"2018-06-21","source_date":"2018-06-21","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/colchicine-cardiovasculair/"],"congress":"","summary_en":"This meta-analysis found that CPAP therapy does not significantly reduce major cardiovascular events in patients with obstructive sleep apnea, disappointing expectations that treating nocturnal airway obstruction would translate to cardiovascular protection.","created":"2026-07-03T10:27:20Z","updated":"2026-07-03T13:26:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse naar het effect van CPAP op cardiovasculaire events bij patiënten met obstructieve slaapapneu. Teleurstellend: geen significante reductie ondanks verbetering van de slaapkwaliteit.","abstract_original":"AIMS: To assess whether continuous positive airway pressure (CPAP) therapy reduces major adverse cardiovascular events (MACE) in patients with moderate-to-severe obstructive sleep apnoea (OSA). METHODS AND RESULTS: A total of 235 articles were recovered using MEDLINE, EMBASE and Cochrane library (inception-December 2016) and references contained in the identified articles. Seven randomized controlled trials (RCTs) were selected for final analysis. Analysis of 4268 patients demonstrated non-significant 26% relative risk reduction in MACE with CPAP [risk ratio (RR) 0.74; 95% confidence interval (CI) 0.47-1.17; P = 0.19, I2 = 48%]. A series of sensitivity analyses suggested that increased CPAP usage time yielded significant risk reduction in MACE. and stroke. Subgroup analysis revealed that CPAP adherence time ≥4 hours (h)/night reduced the risk of MACE by 57% (RR 0.43; 95% CI 0.23-0.80; P = 0.01, I2 = 0%). CPAP therapy showed no beneficial effect on myocardial infarction (MI), all-cause mortality, atrial fibrillation/flutter (AF), or heart failure (HF) (P > 0.05). CPAP had positive effect on mood and reduced the daytime sleepiness [Epworth Sleepiness Scale (ESS): mean difference (MD) -2.50, 95% CI - 3.62, -1.39; P < 0.001, I2 = 81%]. CONCLUSION: CPAP therapy might reduce MACE and stroke among subjects with CPAP time exceeding 4 h/night. Additional randomized trials mandating adequate CPAP time adherence are required to confirm this impression."}