Uvulopalatopharyngoplasty reduces the incidence of cardiovascular complications caused by obstructive sleep apnea: results from the national insurance service survey 2007-2014

Sleep Med. 2018 May:45:11-16. doi: 10.1016/j.sleep.2017.12.019. Epub 2018 Feb 9.

Abstract

Objective: Untreated obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease including myocardial infarction (MI), congestive heart failure (CHF), and atrial fibrillation (AF). Continuous positive airway pressure (CPAP) is an effective treatment for OSA; however, compliance with CPAP can be challenging for some patients. The objective of this study was to investigate whether uvulopalatopharyngoplasty (UPPP) reduced the risk of cardiovascular complications for patients with OSA.

Methods: Data from Korea National Health Insurance Corporation, a national health care database in South Korea, were analyzed. All patients with a new diagnosis of OSA from 2007 to 2014 were identified. Propensity score matching by age and sex was used to identify a control group five times larger than the OSA group for comparison. Patient demographics and comorbidities were collected. The OSA group was further divided into patients who had an UPPP and patients who did not undergo surgery. The primary endpoints were newly diagnosed MI, CHF, and AF.

Results: Of 192,316 patients with a new diagnosis of OSA, 22,213 had undergone UPPP. For the control group, 961,590 individuals were selected. Patients with OSA had an increased risk of CHF and AF, compared to control patients. UPPP reduced the incidence of CHF and AF significantly. Age, gender, and hypertension were also found to be risk factors for cardiac complications for patients with OSA.

Conclusion: OSA increases the risk of CHF and AF. UPPP in this population can significantly reduce the risk of cardiac complications in patients with OSA.

Keywords: Atrial fibrillation; Congestive heart failure; Myocardial infarction; Obstructive sleep apnea; Uvulopalatopharyngoplasty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrial Fibrillation / diagnosis
  • Female
  • Heart Diseases / epidemiology*
  • Heart Failure / diagnosis
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Palate / physiopathology
  • Palate / surgery*
  • Pharynx / physiopathology
  • Pharynx / surgery*
  • Republic of Korea / epidemiology
  • Risk Factors
  • Sleep Apnea, Obstructive / physiopathology
  • Sleep Apnea, Obstructive / surgery*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Uvula / physiopathology
  • Uvula / surgery*