Baseline lipid levels and weight gain after one year predict long-term cardiovascular outcomes in adults with coronary artery disease and obstructive sleep apnoea

Abstract

Reducing lipid levels is essential for preventing major adverse cardiovascular and cerebrovascular events (MACCE) in management of coronary artery disease (CAD) patients with obstructive sleep apnoea (OSA). The first line treatment of OSA is continuous positive airway pressure (CPAP), however, its impact on the association between lipid profile and MACCEs is uncertain. Moreover, less is known regarding the association between weight changes and MACCEs. In all, 327 OSA patients (apnoea-hypopnoea-index [AHI]≥15 events/h) on lipid lowering agents from the RICCADSA cohort with available lipid levels at baseline and 12-month follow-up were included. The primary outcome was the first MACCE (repeat revascularization, myocardial infarction, stroke, or cardiovascular mortality). There were no significant differences in circulating levels of lipids at baseline and after 12 months as well as in the amount of change from baseline in lipids and body-mass-index (BMI) between patients on CPAP treatment (n=224) vs no-CPAP (n=103). In adjusted Cox proportional hazard models, baseline HDL and LDL as well as increase in BMI at 12-month follow-up. CAD patients with OSA have an increased risk of MACCEs due to dyslipidemia and weight gain despite lipid-lowering agents and CPAP treatment suggesting that lifestyle modifications should be given priority in these patients. erj;66/suppl_69/PA4550/F1F1F1