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TOPLINE
Among patients with cancer, obstructive sleep apnea (OSA) was associated with higher risk for cardiovascular disease (CVD), particularly heart failure, with women with OSA facing a nearly twofold higher risk for heart failure.
METHODOLOGY
- Researchers conducted a retrospective cohort study using data from the TriNetX US Collaborative Network to evaluate the association between OSA and risk for CVD among patients with cancer.
- They analyzed data from 4,801,487 patients aged 40 years or older who were diagnosed with a new solid or metastatic cancer between 2012 and 2023 after remaining cancer free from 2005 to 2011; of these, 643,143 had OSA and 4,158,344 did not.
- Patients with OSA were matched with those without OSA to balance baseline characteristics, resulting in 629,114 patients in each group. The mean age at cancer diagnosis of the matched cohort was 65 years, and approximately 40% were women.
- The primary outcome was a composite of adverse CVD-related outcomes, including heart failure, atrial fibrillation or flutter, myocardial infarction, coronary revascularization, ischemic stroke, and all-cause mortality.
TAKEAWAY
- Patients with cancer and OSA had a 27% higher risk for the composite CVD outcome compared with those without OSA (hazard ratio [HR], 1.27; 95% CI, 1.26-1.28).
- OSA was associated with higher risks for heart failure (HR, 1.80; 95% CI, 1.78-1.83), atrial fibrillation or flutter (HR, 1.71; 95% CI, 1.69-1.74), myocardial infarction (HR, 1.42; 95% CI, 1.39-1.45), and ischemic stroke (HR, 1.41; 95% CI, 1.38-1.44).
- Despite higher risk for CVD, all-cause mortality was lower among patients with cancer and OSA than those with cancer without OSA (HR, 0.84; 95% CI, 0.83-0.85).
- In subgroup analyses, women with cancer and OSA had nearly twofold higher risk for heart failure compared with women with cancer without OSA (HR, 1.94; 95% CI, 1.89-1.98).
IN PRACTICE
"Our study suggests that patients with a diagnosis of cancer may obtain CVD risk reduction by OSA screening and treatment at cancer diagnosis, and this may be worth testing in a randomized clinical trial," the researchers wrote.
SOURCE
The study was led by Ehimen C. Aneni, MD, MPH, of Yale School of Medicine, New Haven, Connecticut. It was published online on August 20 in the Journal of the American Heart Association.
LIMITATIONS
OSA severity or treatment status was not evaluated. The impact of OSA severity or positive airway pressure therapy on the lower mortality observed among patients with OSA could not be determined. Cancer stage at diagnosis and treatments used to manage cancer were not accounted for and may have influenced heart failure and other cardiovascular outcomes.
DISCLOSURES
The study was supported by a career development award to one of the authors from the Robert A. Winn Foundation, established by the Bristol Myers Squibb Foundation. The authors disclosed no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
