Increased Risk Of Cardiovascular And Cerebrovascular Events In Patients With OSA:A Meta Analysis

Objective: To evaluate the risk of cardiovascular and cerebrovascular events in patients with cardiovascular diseases and complicated with obstructive sleep apnea systematically, and to prompt anesthesiologists pay attention to these patients in the cardiovascular system.Methods: We searched Pub Med, EBSCO, Cochrane Library, Chinese Biomedical Literature Database(CBM), Wan Fang Data, et al. Language set for English or Chinese. Literatures published before December, 2014 and conducted to compare risk of cardiovascular and cerebrovascular events in patients with cardiovascular diseases and complicated with obstructive sleep apnea were enrolled. The enrolled studies may be Randomized controlled trials or Clinical controlled trial. Search words included: "sleep disordered", "obstructive sleep apnea", "cardiovascular and cerebrovascular diseases", coronary heart disease", "atherosclerosis", "myocardial infarction","stroke" et al. Firstly, two authors screened the titles and abstracts independently, identify and exclude irrelevant-literatures clearly. Different opinions will be solved through discussion or consulting with the third researchers. Data were managed by another two authors. Then, we assessed the quality of the enrolled literatures and calculated pooled effects for each outcome in Review manage5.2 or Stata 12.0 software. The data of this study are dichotomous data, so the outcomes were described by relative risk and 95% confidence interval. The results were also showed via drawing Forest plots. Quantified heterogeneity with adapted χ2, P values and I2 for eligible studies. According to the opinions of the Cochrane Collaboration,studies are recognized to be heterogeneity and synthesized with a random-effects model when P < 0.05 or I2 > 50%. Or else, do it by fixed-effect model. For heterogeneity, we would find the sources of heterogeneity in methodology or clinic via subgroup analysis and sensitivity analysis. At last, we evaluate the influenced of published bias by the funnel plots.Results:. A total of 11 foreign literatures involving 2238 cases were included. Of these, seven studies were high articles, four studies had lower quality. The meta analysis results showed that: compared with patients without OSA, patients with OSA had a higher death risk [RR=1.73,95%CI(1.41-2.13)] and higher incidence of adverse events [RR=1.80,95%CI(1.00-3.22)].Conclusion: Patients with obstructive sleep apnea have a higher risk of cardiovascular and cerebrovascular events. Anesthesiologists should pay attention to these patients in cardiovascular system when they under a surgery.