Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
Department of Otorhinolaryngology/Head and Neck Surgery, Samsung Medical Center, Seoul, South Korea.
Sleep Med. 2018 May;45:11-16. doi: 10.1016/j.sleep.2017.12.019. Epub 2018 Feb 9.
Untreated obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease including myocardial infarction (MI), congestive heart failure (CHF), and atrial fibrillation (AF). Continuous positive airway pressure (CPAP) is an effective treatment for OSA; however, compliance with CPAP can be challenging for some patients. The objective of this study was to investigate whether uvulopalatopharyngoplasty (UPPP) reduced the risk of cardiovascular complications for patients with OSA.
Data from Korea National Health Insurance Corporation, a national health care database in South Korea, were analyzed. All patients with a new diagnosis of OSA from 2007 to 2014 were identified. Propensity score matching by age and sex was used to identify a control group five times larger than the OSA group for comparison. Patient demographics and comorbidities were collected. The OSA group was further divided into patients who had an UPPP and patients who did not undergo surgery. The primary endpoints were newly diagnosed MI, CHF, and AF.
Of 192,316 patients with a new diagnosis of OSA, 22,213 had undergone UPPP. For the control group, 961,590 individuals were selected. Patients with OSA had an increased risk of CHF and AF, compared to control patients. UPPP reduced the incidence of CHF and AF significantly. Age, gender, and hypertension were also found to be risk factors for cardiac complications for patients with OSA.
OSA increases the risk of CHF and AF. UPPP in this population can significantly reduce the risk of cardiac complications in patients with OSA.
未经治疗的阻塞性睡眠呼吸暂停（OSA）是包括心肌梗死（MI）、充血性心力衰竭（CHF）和心房颤动（AF）在内的心血管疾病的危险因素。持续气道正压通气（CPAP）是治疗 OSA 的有效方法；然而，一些患者对 CPAP 的依从性可能具有挑战性。本研究的目的是研究悬雍垂腭咽成形术（UPPP）是否降低 OSA 患者发生心血管并发症的风险。
分析来自韩国国家健康保险公社的数据，这是韩国的一个国家医疗保健数据库。确定了 2007 年至 2014 年间新诊断为 OSA 的所有患者。通过年龄和性别进行倾向评分匹配，为 OSA 组匹配了五倍于 OSA 组的对照组进行比较。收集患者的人口统计学和合并症数据。将 OSA 组进一步分为接受 UPPP 手术和未接受手术的患者。主要终点是新发 MI、CHF 和 AF。
在 192316 例新诊断为 OSA 的患者中，有 22213 例接受了 UPPP。为对照组选择了 961590 名个体。与对照组患者相比，OSA 患者发生 CHF 和 AF 的风险增加。UPPP 显著降低了 CHF 和 AF 的发生率。年龄、性别和高血压也被发现是 OSA 患者发生心脏并发症的危险因素。
OSA 增加了 CHF 和 AF 的风险。在该人群中，UPPP 可显著降低 OSA 患者心脏并发症的风险。
