A Meta-analysis Of Continuous Positive Airway Pressure Therapy In Patients With Coronary Heart Disease And Obstructive Sleep Apnoea

Object:To evaluate whether continuous positive pressure ventilation can reduce the incidence of adverse cardiovascular events in patients with coronary heart disease complicated with moderate to severe obstructive sleep apnoea.Methods:Using The paper retrieval system,The two researchers searched The randomized controlled trials of continuous positive airway pressure in patients with moderate to severe obstructive sleep apnoea and coronary heart disease in The Cochrane Library,EMbase,PubMed,CnKI and WanFang(inception-October 2020)and references contained in the identified articles.Two researchers independently conducted literature retrieval,screening and data extraction,and conducted quality evaluation on the included studies.All data were extracted and summarized in Excel,and meta analysis was carried out using ReVman5.2 and Stata15 software.All outcome variables of dichotomy were combined according to the principle of intentional treatment,and were expressed as relative risk RR and 95%confidence interval(CI).Results:A total of 156 relevant literatures were detected,and 4 RCTS were finally included.3062 patients were included,and the median follow-up time was 36-56.9 months.The results showed that the incidence of complex cardiovascular events in patients with coronary heart disease and obstructive sleep apnoea treated with continuous positive airway pressure was not statistically significant compared with the control group[RR=0.99,95%CI(0.85-1.15),P=0.88].Further subgroup analysis of CPAP compliance and cumulative meta analysis showed that the results were not statistically significant.Secondary outcomes during follow-up,including acute myocardial infarction[RR=1.06(0.72-1.57),P=0.76],hospitalized heart failure[RR=0.93(0.661.31),P=0.67],stroke[RR=0.79(0.37-1.70),P=0.54],cardiac death[RR=0.69(0.361.30),P=0.25]and all-cause mortality[RR=0.81(0.52-1.25),P=0.34],were not statistically significant.Conclusion:Compared with conventional treatment,continuous positive airway pressure can not improve the incidence of cardiovascular events in patients with coronary heart disease and moderate to severe obstructive sleep apnoea.