{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T02:52:49Z","timestamp":1782355969855,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,3]],"date-time":"2018-03-03T00:00:00Z","timestamp":1520035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2018,5]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Previous studies suggested obstructive sleep apnoea syndrome (OSAS<\/jats:styled-content>) as a major risk factor for incident cardiovascular events. However, the relationship between OSAS<\/jats:styled-content> severity, the use of continuous positive airway pressure (CPAP<\/jats:styled-content>) treatment and the development of cardiovascular disease is still matter of debate.<\/jats:p><\/jats:sec>Study objectives<\/jats:title>The aim was to test the association between OSAS<\/jats:styled-content> and cardiovascular events in patients with concomitant cardio\u2010metabolic diseases and the potential impact of CPAP<\/jats:styled-content> therapy on cardiovascular outcomes.<\/jats:p><\/jats:sec>Methods<\/jats:title>Prospective observational cohort study of consecutive outpatients with suspected metabolic disorders who had complete clinical and biochemical workup including polysomnography because of heavy snoring and possible OSAS<\/jats:styled-content>. The primary endpoint was a composite of major adverse cardiovascular and cerebrovascular events (MACCE<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>Median follow\u2010up was 81.3 months, including 434 patients (2701.2 person\/years); 83 had a primary snoring, 84 had mild, 93 moderate and 174 severe OSAS<\/jats:styled-content>, respectively. The incidence of MACCE<\/jats:styled-content> was 0.8% per year (95% confidence interval [CI<\/jats:styled-content>] 0.2\u20102.1) in primary snorers and 2.1% per year (95% CI<\/jats:styled-content> 1.5\u20102.8) for those with OSAS<\/jats:styled-content>. A positive association was observed between event\u2010free survival and OSAS<\/jats:styled-content> severity (log\u2010rank test; P<\/jats:italic> = .041). A multivariable Cox regression analysis showed obesity (HR<\/jats:styled-content> = 8.011, 95% CI<\/jats:styled-content> 1.071\u201059.922, P<\/jats:italic> = .043), moderate OSAS<\/jats:styled-content> (vs non\u2010OSAS HR<\/jats:styled-content> = 3.853, 95% CI<\/jats:styled-content> 1.069\u201013.879, P<\/jats:italic> = .039) and severe OSAS<\/jats:styled-content> (vs non\u2010OSAS HR<\/jats:styled-content> = 3.540, 95% CI<\/jats:styled-content> 1.026\u201012.217, P<\/jats:italic> = .045) as predictors of MACCE<\/jats:styled-content>. No significant association was observed between CPAP<\/jats:styled-content> treatment and MACCE<\/jats:styled-content> (log\u2010rank test; P<\/jats:italic> = .227).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our findings support the role of moderate\/severe OSAS<\/jats:styled-content> as a risk factor for incident MACCE<\/jats:styled-content>. CPAP<\/jats:styled-content> treatment was not associated with a lower rate of MACCE<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12908","type":"journal-article","created":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T07:22:52Z","timestamp":1518160972000},"source":"Crossref","is-referenced-by-count":34,"title":["Severity of OSAS, CPAP and cardiovascular events: A follow\u2010up study"],"prefix":"10.1111","volume":"48","author":[{"given":"Francesco","family":"Baratta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy"},{"name":"Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-5213","authenticated-orcid":false,"given":"Daniele","family":"Pastori","sequence":"additional","affiliation":[{"name":"Department 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