In-hospital Outcomes and Arrhythmia Burden in Patients with Obstructive Sleep Apnea and Heart Failure with Preserved Ejection Fraction
Patients with obstructive sleep apnea (OSA) have an increased risk for arrhythmias compared to patients without OSA. However, data quantifying the risk of inpatient complications in patients with heart failure with preserved ejection fraction (HFpEF) are lacking. We sought to compare inpatient outco...
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Published in | The Journal of innovations in cardiac rhythm management (Print) Vol. 13; no. 6; pp. 5033 - 5040 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
United States
MediaSphere Medical
01.06.2022
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Abstract | Patients with obstructive sleep apnea (OSA) have an increased risk for arrhythmias compared to patients without OSA. However, data quantifying the risk of inpatient complications in patients with heart failure with preserved ejection fraction (HFpEF) are lacking. We sought to compare inpatient outcomes and the occurrence of arrhythmias in patients with HFpEF with and without OSA, respectively. Furthermore, we compared the prevalence of arrhythmias with nocturnal continuous positive airway pressure (CPAP) therapy. We performed a retrospective study using the National Inpatient Sample from 2016–2018 to identify patients with HFpEF with and without OSA. Propensity score matching, adjusting for age, gender, race, hospital characteristics, income, and comorbidities, was used to select matched samples between both groups. From 2016–2018, 127,773 hospitalizations with HFpEF were identified; among these patients, 20% had OSA. Nocturnal CPAP was utilized in 9% of these patients. Patients with OSA had a higher mortality rate, a longer duration of hospitalization, and greater medical costs. In addition, OSA was associated with higher incidence rates of atrial fibrillation, atrial flutter, premature depolarization, sick sinus syndrome, ventricular tachycardia, and atrioventricular block. Nocturnal CPAP was not associated with a lower arrhythmia incidence; however, there was a non-significant trend toward a lower cardiac arrest incidence. In conclusion, OSA in patients with HFpEF was associated with greater mortality, longer hospitalization stays, and higher medical costs relative to findings in patients without OSA. Furthermore, OSA was associated with tachyarrhythmias and bradyarrhythmias in HFpEF patients. Nocturnal CPAP was only utilized in 9% of patients, with no difference in arrhythmogenesis. |
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AbstractList | Patients with obstructive sleep apnea (OSA) have an increased risk for arrhythmias compared to patients without OSA. However, data quantifying the risk of inpatient complications in patients with heart failure with preserved ejection fraction (HFpEF) are lacking. We sought to compare inpatient outcomes and the occurrence of arrhythmias in patients with HFpEF with and without OSA, respectively. Furthermore, we compared the prevalence of arrhythmias with nocturnal continuous positive airway pressure (CPAP) therapy. We performed a retrospective study using the National Inpatient Sample from 2016–2018 to identify patients with HFpEF with and without OSA. Propensity score matching, adjusting for age, gender, race, hospital characteristics, income, and comorbidities, was used to select matched samples between both groups. From 2016–2018, 127,773 hospitalizations with HFpEF were identified; among these patients, 20% had OSA. Nocturnal CPAP was utilized in 9% of these patients. Patients with OSA had a higher mortality rate, a longer duration of hospitalization, and greater medical costs. In addition, OSA was associated with higher incidence rates of atrial fibrillation, atrial flutter, premature depolarization, sick sinus syndrome, ventricular tachycardia, and atrioventricular block. Nocturnal CPAP was not associated with a lower arrhythmia incidence; however, there was a non-significant trend toward a lower cardiac arrest incidence. In conclusion, OSA in patients with HFpEF was associated with greater mortality, longer hospitalization stays, and higher medical costs relative to findings in patients without OSA. Furthermore, OSA was associated with tachyarrhythmias and bradyarrhythmias in HFpEF patients. Nocturnal CPAP was only utilized in 9% of patients, with no difference in arrhythmogenesis. |
Author | WU, CHUNYI GILL, JASHAN |
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CitedBy_id | crossref_primary_10_5664_jcsm_11000 crossref_primary_10_1007_s40675_024_00275_y crossref_primary_10_1016_j_cpcardiol_2023_102139 crossref_primary_10_1016_j_smrv_2023_101854 |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The authors report no conflicts of interest for the published content. No funding information was provided. |
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Title | In-hospital Outcomes and Arrhythmia Burden in Patients with Obstructive Sleep Apnea and Heart Failure with Preserved Ejection Fraction |
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