GLAUCYLARA REIS GEOVANINI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/13 - Laboratório de Genética e Cardiologia Molecular, Hospital das Clínicas, Faculdade de Medicina

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  • article 20 Citação(ões) na Scopus
    OSA and Prognosis After Acute Cardiogenic Pulmonary Edema The OSA-CARE Study
    (2017) UCHOA, Carlos Henrique G.; PEDROSA, Rodrigo P.; JAVAHERI, Shahrokh; GEOVANINI, Glaucylara R.; CARVALHO, Martinha M. B.; TORQUATRO, Ana Claudia S.; LEITE, Ana Paula D. L.; GONZAGA, Carolina C.; BERTOLAMI, Adriana; AMODEO, Celso; PETISCO, Ana Claudia G. P.; BARBOSA, Jose Eduardo M.; MACEDO, Thiago A.; BORTOLOTTO, Luiz A.; OLIVEIRA JR., Mucio Tavares; LORENZI-FILHO, Geraldo; DRAGER, Luciano F.
    BACKGROUND: Acute cardiogenic pulmonary edema (ACPE) is a life-threatening condition. OSA may be a modifiable risk factor for ACPE recurrence. This study was designed to evaluate the impact of OSA on the incidence of cardiovascular events following ACPE recovery. METHODS: Consecutive patients with confirmed ACPE from 3 centers underwent a sleep study following clinical stabilization. OSA was defined as an apnea-hypopnea index (AHI) >= 15 events/h. The mean follow-up was 1 year, and the primary outcome was ACPE recurrence. RESULTS: A total of 104 patients were included in the final analysis; 61% of the patients had OSA. A higher rate of ACPE recurrence (25 vs 6 episodes; P = .01) and a higher incidence of myocardial infarction (15 vs 0 episodes; P = .0004) were observed in patients with OSA than in those without OSA. All 17 deaths occurred in the OSA group (P = .0001). In a Cox proportional hazards regression analysis, OSA was independently associated with ACPE recurrence (hazard ratio [HR], 3.3 [95% CI, 1.2-8.8]; P = .01), incidence of myocardial infarction (HR, 2.3 [95% CI, 1.1-9.5]; P = .02), cardiovascular death (HR, 5.4 [95% CI, 1.4-48.4]; P = .004), and total death (HR, 6.5 [95% CI, 1.2-64.0]; P = .005). When the analysis was limited only to patients with OSA, levels of AHI and hypoxemic burden and rates of sleep-onset ACPE were significantly higher in those who presented with ACPE recurrence or who died than in those who did not experience these events. CONCLUSIONS: OSA is independently associated with higher rates of ACPE recurrence and both fatal and nonfatal cardiovascular events.