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Continuous Positive Airway Pressure for Heart Patients with Central Sleep Apnea

Continuous Positive Airway Pressure for Heart Patients with Central Sleep Apnea

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Continuous Positive Airway Pressure for Heart Patients with Central Sleep Apnea

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  1. CANPAP Continuous Positive Airway Pressure for Heart Patients with Central Sleep Apnea Presented at American College of Cardiology Scientific Sessions 2005 Presented by Dr. T. Douglas Bradley

  2. CANPAP 258 patients age 18-79 with heart failure, ejection fraction < 40%, and central sleep apnea despite optimal medical therapy Randomized. Mean age 63 years. Baseline ejection fraction 24.5% Nocturnal CPAP† Titrated as tolerated to 10 cmH2O n=128 No CPAP n=130 • Endpoints (mean follow-up 2 years): • Primary: Death or heart transplantation • Secondary: Apnea hypopnea index, quality of life † CPAP was used an average of 4 hours per day during the trial Presented at ACC Scientific Sessions 2005

  3. CANPAP Primary Endpoint: Death or hospitalization p=0.54 • Average sleep time was 304 minutes in the CPAP group and 308 minutes in the control group. Apnea hypopnea index at baseline was 40 apneas/hour • There was no difference in the frequency of death or hospitalization between groups or in the cumulative number of hospitalizations (p=0.83) Presented at ACC Scientific Sessions 2005

  4. CANPAP: 12 weeks Secondary Endpoints in the Nocturnal CPAP group Apnea Hypopnea Index P<0.001 Norepinephrine p=0.014 • The CPAP group had larger decreases in apnea hypopnea index and norepinephrine than the control group Presented at ACC Scientific Sessions 2005

  5. CANPAP: 12 weeks Secondary Endpoints in the Nocturnal CPAP group Mean nocturnal oxygen saturation P<0.001 • The CPAP group had a higher nocturnal oxygen saturation and ejection fraction than the control group • There were no differences in quality of life or exercise duration Ejection fraction P<0.05 Presented at ACC Scientific Sessions 2005

  6. CANPAP • Among heart failure patients with central sleep apnea, use of continuous positive airway pressure was not associated with reductions in death or need for transplantation by 2 years compared with control patients • Despite some beneficial findings in apnea hypopnea index, norepinephrine, oxygen saturation, and ejection fraction, the overall clinical event rate was much lower than expected, prompting early discontinuation of the trail Presented at ACC Scientific Sessions 2005