- CANPAP研究
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Continuous Positive Airway Pressure for Heart Patients with Central Sleep Apnea
Presented at
American College of Cardiology
Scientific Sessions 2005
Presented by Dr. T. Douglas Bradley
CANPAP
Endpoints (mean follow-up 2 years):
Primary: Death or heart transplantation
Secondary: Apnea hypopnea index, quality of life
CANPAP
Presented at ACC Scientific Sessions 2005
258 patients age 18-79 with heart failure, ejection fraction < 40%, and central sleep apnea despite optimal medical therapy
Randomized. Mean age 63 years. Baseline ejection fraction 24.5%
Nocturnal CPAP?
Titrated as tolerated to 10 cmH2O
n=128
No CPAPn=130
? CPAP was used an average of 4 hours per day during the trial
Presented at ACC Scientific Sessions 2005
Primary Endpoint: Death or hospitalization
p=0.54
CANPAP
Average sleep time was 304 minutes in the CPAP group and 308 minutes in the control group. Apnea hypopnea index at baseline was 40 apneas/hour
There was no difference in the frequency of death or hospitalization between groups or in the cumulative number of hospitalizations (p=0.83)
Presented at ACC Scientific Sessions 2005
Secondary Endpoints in the Nocturnal CPAP group
CANPAP: 12 weeks
The CPAP group had larger decreases in apnea hypopnea index and norepinephrine than the control group
Apnea Hypopnea Index
P<0.001
Norepinephrine
p=0.014
Presented at ACC Scientific Sessions 2005
Secondary Endpoints in the Nocturnal CPAP group
CANPAP: 12 weeks
The CPAP group had a higher nocturnal oxygen saturation and ejection fraction than the control group
There were no differences in quality of life or exercise duration
Mean nocturnal oxygen saturation
P<0.001
Ejection fraction
P<0.05
Among heart failure patients with central sleep apnea, use of continuous positive airway pressure was not associated with reductions in death or need for transplantation by 2 years compared with control patients
Despite some beneficial findings in apnea hypopnea index, norepinephrine, oxygen saturation, and ejection fraction, the overall clinical event rate was much lower than expected, prompting early discontinuation of the trail
Presented at ACC Scientific Sessions 2005
CANPAP
