Obstructive Sleep Apnea Independently Increases the Incidence of Heart Failure and Major Adverse Cardiac Events: A Retrospective Population-Based Follow-Up Study.

Background: Obstructive sleep apnea (OSA) is common in heart failure (HF) patients and exacerbates the outcome of this chronic disease. However, the frequency of HF arising from OSA is varied, with little supporting literature. Here, we aimed to clarify the incidence risk of HF and major adverse cardiac events (MACEs) in OSA patients from the Taiwan large database.

Methods and Results: From 2000-2010, a total of 2699 newly diagnosed OSA patients after polysomnographic study and 13,490 non-OSA patients utilizing 1:5 matching was enrolled and followed to 2011. Compared to the non-OSA cohort, the OSA cohort increased its MACEs incidence 1.95-fold high and HF incidence reached its highest level, up to 2.75-fold [confidential interval (CI): 1.76-4.29; p value < 0.001]. The most common MACE event was stroke, with a 1.75-fold higher risk in the OSA cohort (CI: 1.37-2.20; p value < 0.001). Although the trend is similar, the OSA cohort showed an increased incidence of atrial fibrillation of approximately 1.63-fold high, (CI: 0.78-3.40; p value: 0.193) and 1.44 high, (CI: 0.74-2.79; p value: 0.287) in myocardial infarction. Between genders, HF risk is considerably higher in female OSA cohort than in corresponding males [female: 6.13 (2.68-14.00), p value < 0.01; male: 1.95 (1.11-3.43), p value = 0.020].

Conclusions: OSA patients have nearly triple the HF incidence risk than the non-OSA population, particularly in female OSA patients.