Copyright © 2004 by the European Society of Cardiology.
Clinical research
Benefits of obstructive sleep apnoea treatment in coronary artery disease: a long-term follow-up study
a Division of Cardiology, Ambroise Paré Teaching Hospital, AP-HP, UFR Paris-Ile de France-Ouest, Université de Versailles-Saint Quentin en Yvelines, 92104 Boulogne, France
b Sleep Laboratory Unit, Ambroise Paré Teaching Hospital, AP-HP, UFR Paris-Ile de France-Ouest, Université de Versailles-Saint Quentin en Yvelines, 92104 Boulogne, France
c Biostatistics and Medical Informatics Unit, Ambroise Paré Teaching Hospital, AP-HP, UFR Paris-Ile de France-Ouest, Université de Versailles-Saint Quentin en Yvelines, 92104 Boulogne, France
Received August 26, 2003;
revised January 30, 2004;
accepted February 5, 2004
* Corresponding author. Tel.: +33-1-49-09-56-11; fax: +33-1-49-09-58-85
E-mail address: olivier.milleron{at}apr.ap-hop-paris.fr
See page 709 for the editorial comment on this article1
Aim The aim of this long-term prospective study was to evaluate the effect of treating obstructive sleep apnoea (OSA) on the rate of cardiovascular events in coronary artery disease (CAD).
Methods and results We prospectively studied 54 patients (mean age 57.3±10.1 years) with both CAD (
70% coronary artery stenosis) and OSA (apnoea–hypopnoea index 15). In 25 patients, OSA was treated with continuous positive airway pressure 
or upper airway surgery 
; the remaining 29 patients declined treatment for their OSA. The median follow-up was 86.5±39 months. The two groups were similar at baseline in age, body mass index, smoking history, hypertension, hypercholesterolaemia, diabetes mellitus, number of diseased vessels, left ventricular ejection fraction, and CAD therapy. Treatment of risk factors other than OSA was similar in the two groups. The endpoint (a composite of cardiovascular death, acute coronary syndrome, hospitalisation for heart failure, or need for coronary revascularisation) was reached in 6 (6/25, 24%) and 17 (17/29, 58%) patients with and without OSA treatment, respectively 
. OSA treatment significantly reduced the risk of occurrence of the composite endpoint (hazard ratio 0.24; 95% confidence interval, 0.09–0.62; 
) and of each of its components.
Conclusions Our data indicate that the treatment of OSA in CAD patients is associated with a decrease in the occurrence of new cardiovascular events, and an increase in the time to such events.
Key Words: Obstructive sleep apnoea • Coronary artery disease
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