Can Cpap postpone a likely MI?

[Julie]

I just asked Google that question and did not see one relevant answer... the closest one talked about people with OSAH (OSA hypopnea) and did not give a definitive answer... very frustrating all around. I was hoping to get something more useful than the thread with the other study that everyone's dissing, and wanted to see what another might say about patients who may not yet have shown cardiovascular problems or events, never mind been in badly done studies, and if someone here can find something (e.g. since 2010) that addresses my Q, I'd be very interested in seeing it.

[Wulfman...]

I would say.......DEFINITELY......"MAYBE".

https://en.wikipedia.org/wiki/Myocardial_infarction

http://www.mayoclinic.org/diseases-cond ... n-20019520

This was the Google search I used.

https://www.google.com/search?q=what+is ... infarction

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111232/

An excerpt from that link:

"At the present time there are no large randomised controlled trials which have examined the impact of long term CPAP treatment in patients with OSAH on more robust CVD outcomes such as incident strokes or heart attacks. However, observational studies have suggested improved CVD outcomes in patients with OSAH using CPAP compared with patients on no treatment. Peker and colleagues prospectively followed 182 middle aged men referred for a sleep study with no hypertension or CVD at baseline.22 Incident CVD (hypertension, coronary artery disease, stroke, myocardial infarction, arrhythmias) over 7 years occurred in 37% of patients with OSAH compared with 6.6% of those without OSAH. CVD events were much more frequent in patients who were incompletely treated for their OSAH (56% over 7 years) than in those who were well treated (6.7%) Incompletely treated OSAH remained a strong independent risk factor for incident CVD after controlling for potential confounders."


Den

.

[Sir NoddinOff]

Myocardial infarction (MI).

From what I've heard from my doctors, the jury is still out about CPAP and heart disease prevention. All doctors agree good sleep can help somewhat. In other words CPAP is NOT a magic bullet. My personal feeling is that CPAP can't scrub the plaque build-up out your arteries from years of eating chili dogs (Not that you eat chili dogs).

Sorry Julie, I can't cite peer studies... never cared enough to look for them. Your doctor can probably give you some answers.

Are you getting periodic chest pains/pressure or shortness of breath... numbness in the hands or arms? Difficulty climbing stairs or hills. Diagnosis can be difficult, a lot of symptoms mimic mid to latter stage heart disease.

[Julie]

Oh no, not personal thanks, and if it were, I'd go to the doctor or ER... the article cited by Den - end of his post - is the one I mentioned re hypopneas, but while I know no one has a crystal ball - maybe my question is dumb - if a clinical trial is long enough (years) and the pop. representative of the general population re age, habits, exam, etc. a certain number of those people will statistically have attacks whether or not they had any prior signs, so the effect can sort of be measured, though not the way they handled it in that other thread here. It would just be interesting to know of some hard research that was done, something to once and for all show that the likelihood of getting MIs if using Cpap is thought to be better by e.g. 5 yrs than it would be if Cpap was not used. Cpap is SUPPOSED to prevent all kinds of problems, but finding the (valid) literature is not at all easy.

[Pneumophile]

The best way that I know of to run a search of the clinical/scientific literature is to go to the NIH/NCI database. It's called PubMed, is free for all to use and is pretty complete (global literature). I've been doing this myself for a long long time. Here's the link:

http://www.ncbi.nlm.nih.gov/m/pubmed/

With older papers they often let you download the pdf. For more recent ones you often can't, for copyright reasons.

In a subset analysis of patients in the recent Spanish study that you will quickly come across in a search, patients who spent > 4 hr on the blower showed improvement in certain CV endpoints compared with no-CPAP controls. However, as was the case for the big study in the other thread (McEvoy et al, 2016), there was no benefit for the full study population (for which compliance was poor). Until a well powered study is done on patients who have good blower compliance, this important question is likely to remain open.
Cheers!

[chunkyfrog]

Regular care for each condition should be continued in any case.
Like keeping all your tires inflated.

[Julie]

Pneumophile - the article I mentioned in my 1st post (that Den then cited) is an NIH pub.

[Pneumophile]

Sure. I mentioned PubMed as an alternative to Google if you want to look further. I use both myself.

[Guest]

Try Google Scholar

[Goofproof]

Are you planning on having one? My advice would be dont! Jim They arent as much fun as advertized.

[D.H.]

First, let me reiterate that I am not a doctor and what I am saying should not be considered medical advice.

Most studies state that CPAP compliance indeed does improve heart health. There's a more recent study that appears to indicate otherwise, but that study appears to be on patients who are only marginally compliant.

Note that the expected improvement in heart health is based on long-term and consistent compliance. If you're asking "will using CPAP tonight prevent me from having a myocardial infarction tonight?," the answer is not clear (but even that is possible).

[Pneumophile]

Try Google Scholar

I'll have to do that and compare with PubMed.