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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

OSA and Prognosis After Acute Cardiogenic Pulmonary Edema The OSA-CARE Study

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Autor(es):
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Uchoa, Carlos Henrique G. [1, 2] ; Pedrosa, Rodrigo P. [3] ; Javaheri, Shahrokh [4, 5] ; Geovanini, Glaucylara R. [2] ; Carvalho, Martinha M. B. [3] ; Torquatro, Ana Claudia S. [3] ; Leite, Ana Paula D. L. [3] ; Gonzaga, Carolina C. [6] ; Bertolami, Adriana [6] ; Amodeo, Celso [6] ; Petisco, Ana Claudia G. P. [7] ; Barbosa, Jose Eduardo M. [7] ; Macedo, Thiago A. [1] ; Bortolotto, Luiz A. [1] ; Oliveira, Jr., Mucio Tavares [8] ; Lorenzi-Filho, Geraldo [2] ; Drager, Luciano F. [1, 9]
Número total de Autores: 17
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Med Sch, Heart Inst InCor, Hypertens Unit, Cardiol Div, Sao Paulo - Brazil
[2] Univ Sao Paulo, Med Sch, Heart Inst InCor, Sleep Lab, Pulm Div, Sao Paulo - Brazil
[3] Univ Pernambuco, Pronto Socorro Cardiol Pernambuco PROCAPE, Sleep & Heart Lab, Recife, PE - Brazil
[4] Univ Cincinnati, Coll Med, Bethesda North Hosp, Cincinnati, OH - USA
[5] Ohio State Med Sch, Div Cardiol, Columbus, OH - USA
[6] Dante Pazzanese Inst Cardiol, Sleep Lab & Hypertens Unit, Sao Paulo - Brazil
[7] Dante Pazzanese Inst Cardiol, Echocardiog Dept, Sao Paulo - Brazil
[8] Univ Sao Paulo, Med Sch, Heart Inst InCor, Emergency Dept, Cardiol Div, Sao Paulo - Brazil
[9] Univ Sao Paulo, Med Sch, Hypertens Unit, Nephrol Div, Sao Paulo - Brazil
Número total de Afiliações: 9
Tipo de documento: Artigo Científico
Fonte: CHEST; v. 152, n. 6, p. 1230-1238, DEC 2017.
Citações Web of Science: 9
Resumo

BACKGROUND: Acute cardiogenic pulmonary edema (ACPE) is a life-threatening condition. OSA may be a modifiable risk factor for ACPE recurrence. This study was designed to evaluate the impact of OSA on the incidence of cardiovascular events following ACPE recovery. METHODS: Consecutive patients with confirmed ACPE from 3 centers underwent a sleep study following clinical stabilization. OSA was defined as an apnea-hypopnea index (AHI) >= 15 events/h. The mean follow-up was 1 year, and the primary outcome was ACPE recurrence. RESULTS: A total of 104 patients were included in the final analysis; 61% of the patients had OSA. A higher rate of ACPE recurrence (25 vs 6 episodes; P = .01) and a higher incidence of myocardial infarction (15 vs 0 episodes; P = .0004) were observed in patients with OSA than in those without OSA. All 17 deaths occurred in the OSA group (P = .0001). In a Cox proportional hazards regression analysis, OSA was independently associated with ACPE recurrence (hazard ratio {[}HR], 3.3 {[}95% CI, 1.2-8.8]; P = .01), incidence of myocardial infarction (HR, 2.3 {[}95% CI, 1.1-9.5]; P = .02), cardiovascular death (HR, 5.4 {[}95% CI, 1.4-48.4]; P = .004), and total death (HR, 6.5 {[}95% CI, 1.2-64.0]; P = .005). When the analysis was limited only to patients with OSA, levels of AHI and hypoxemic burden and rates of sleep-onset ACPE were significantly higher in those who presented with ACPE recurrence or who died than in those who did not experience these events. CONCLUSIONS: OSA is independently associated with higher rates of ACPE recurrence and both fatal and nonfatal cardiovascular events. (AU)

Processo FAPESP: 12/02953-2 - Impacto da apneia obstrutiva do sono e da duração do sono sobre a progressão das doenças cardiovasculares
Beneficiário:Luciano Ferreira Drager
Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores