LANDMARK: Long-term cardiovascular outcomes in patients with OSA

Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046-53.

  • This landmark paper performed a long-term prospective controlled study to look at the risk of cardiovascular events in patients who had obstructive sleep apnea (OSA).
  • Patients included in this study were men with history of simple snoring, various levels or obstructive sleep apnea along or healthy men with similar matched age and BMI. OSA severity was determined by their apnea-hypopnea index (AHI). Patients were followed yearly for an average of 10 years. This study evaluated fatal and non-fatal cardiovascular events.
  • The study included 264 healthy males, 377 men who snored (AHI <5), 403 men with untreated mild to moderate OSA, 235 with untreated severe OSA, and 372 men with OSA treated with CPAP.
  • Untreated severe patients had significantly more fatal and non-fatal events than patients in all other groups. Multivariate analysis showed that untreated severe OSA significantly increased the risk for fatal and non-fatal cardiovascular events compared to healthy patients, even after adjusting for confounders.
  • Patients who were treated and compliant with CPAP therapy had similar rates of all cardiovascular events as simple snorers and the healthy population.

PMID: 15781100