CPAP/BiPAP Compliance Improves Survival in LVAD Recipients with Obstructive Sleep Apnea

Area of Science:

• Cardiology
• Pulmonology
• Medical Devices

Background:

• Obstructive sleep apnea (OSA) is prevalent in heart failure (HF) patients, worsening with disease severity.
• Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) improve outcomes in general HF populations.
• The impact of CPAP/BiPAP on survival in left ventricular assist device (LVAD) recipients with OSA is not well-established.

Purpose of the Study:

• To investigate the effect of OSA on long-term survival in newly implanted LVAD patients.
• To determine if CPAP/BiPAP treatment offers mortality benefits in LVAD patients with OSA.

Main Methods:

• Single-center retrospective study of LVAD recipients (January 2007 - February 2022).
• Stratification by OSA status and CPAP/BiPAP compliance.
• Kaplan-Meier survival analysis and Cox proportional hazards modeling.

Main Results:

• Patients with OSA had higher BMI, hypertension, and ICD placement rates pre-LVAD implantation.
• OSA was not linked to increased postoperative complications.
• While overall survival did not differ between OSA and non-OSA groups, compliant OSA patients showed significantly better survival than non-compliant patients (p=0.0099).

Conclusions:

• Consistent CPAP/BiPAP use is associated with improved survival in LVAD patients with OSA.
• CPAP/BiPAP represents a low-risk intervention to reduce mortality in this cohort.
• Increased perioperative OSA screening for LVAD candidates is recommended; multicenter studies are warranted.