Analysis of over 4 million patient records highlights the importance
of diagnosis and effective treatment of this prevalent cardiac
co-morbidity
BARCELONA--(BUSINESS WIRE)--Aug. 31, 2014--
ResMed (NYSE: RMD), a pioneer and global leader in sleep and respiratory
medicine, today announced results from a major analysis of the German
Statutory Health Insurance (SHI) database presented at a Rapid Fire
session at the ESC Congress 2014 in Barcelona, Spain. Results showed
that the three-year mortality of people with sleep apnoea – a prevalent
co-morbidity in coronary heart disease (CHD) and heart failure (HF) –
was significantly lower in patients who were treated with positive
airway pressure (PAP) devices compared to a comparable cohort that
received no PAP treatment. Mortality was reduced by 37.9% in patients
with CHD (p=0.0002) and by 31.6% in patients with HF (p<0.0001).
“Sleep apnoea is a highly prevalent co-morbidity in both coronary heart
disease and heart failure, yet it remains frequently undiagnosed and
thus undertreated,” said Professor Michael Böhm, Professor of
Cardiology, University of the Saarland, Homburg, Germany and co-author
of the analysis. “The results from this analysis highlight just how
important it can be to identify and appropriately treat this condition,
not only to improve quality of life, but also patient survival. It is
vital that, as a community, cardiologists do more to recognise this and
explore how we can ensure patients receive respiratory device therapy
when needed.”
The analysis assessed outcomes for a total of over 4 million individuals
covered by the SHI database (approximately 5% of the German SHI
population). A group of patients with sleep apnoea being treated with
PAP therapy was chosen (4,068 patients). Propensity score was used to
define a control group of an equal number of patients with sleep apnoea
who received no PAP treatment. Patients were followed over three years
after initiation of their PAP therapy with results showing that the
three-year mortality rate was significantly lower in patients treated
with PAP compared with the no PAP group (4.5% vs 7.2%, 37.5% reduction;
p<0.0001). Three-year rates for CHD mortality (4.5% vs 7.2%, 37.9%
reduction; p=0.0002) and HF mortality (14.7% vs 21.4%, 31.6% reduction;
p<0.0001) were also significantly lower in the PAP vs. no PAP group.1
In the spotlight at the ESC Congress 2014: A
route to simpler, more accurate diagnosis of sleep apnoea
An additional study presented at the ESC Congress 2014, has highlighted
that HF patients with sleep-disordered breathing (SDB, also referred to
as sleep apnoea) could be more accurately diagnosed through longer-term
use of the at-home, contactless SleepMinderTM device than
through a single hospital-based polysomnography (PSG) assessment, which
is currently the gold-standard of care.2 This study also
noted potential for misdiagnosis from overnight assessments compared to
just two weeks of home-based analysis with SleepMinderTM.
HF affects around 15 million people in Europe and it is thought that
between 50-75% of these patients will have some form of sleep apnoea.3,4,5
It is the most common HF co-morbidity, yet is also one of the least
recognised by cardiologists, despite being linked to poorer outcomes
including mortality, hospitalisations and quality of life.6
The investigating team reported that, after just two weeks assessment
with SleepMinderTM, 57% of patients were consistently above a
threshold that would require treatment for their SDB (AHI≥15). This rose
to 74% in patients who were followed up for 12 months. The study also
noted that SDB diagnosis via a single night of inpatient PSG frequently
lead to an underestimation of a patient’s SDB severity when compared to
a two week assessment with SleepMinderTM.
ResMed in cardiology: SERVE-HF, the largest
randomised trial of sleep-disordered breathing in heart failure
A common type of SDB, central sleep apnoea with Cheyne-Stokes
respiration (CSA-CSR), can be successfully treated with PaceWaveTM
Adaptive Servo-Ventilation (ASV) therapy. In 2013 ResMed completed
enrolment of the 1,325th patient in SERVE-HF, the world’s
largest randomised study investigating by what degree the treatment of
central SDB (CSA-CSR) with PaceWaveTM ASV may improve
survival and outcomes of patients with stable HF. Results are expected
to report in 2015 and could lead to significant changes in cardiology
clinical practice.
Study information, updates, and news can be obtained at the dedicated
SERVE-HF study website www.servehf.com.
# ENDS #
NOTES TO EDITORS
About ResMed
ResMed is a leading developer, manufacturer and distributor of medical
equipment for treating, diagnosing and managing SDB and other
respiratory disorders. We are dedicated to developing innovative
products to improve the lives of those who suffer from these conditions
and to increasing awareness among patients and healthcare professionals
of the potentially serious health consequences of untreated SDB. For
more information on ResMed, visit www.resmed.com.
References
1 H. Woehrle et al. Benefit of positive airway pressure (PAP)
therapy in patients with sleep apnoea (SA) in Germany: a retrospective
comparative cohort analysis based on a statutory health insurance (SHI)
database. ESC Congress 2014, abstract 90918 - presented as part of the
Rapid Fire session on 31 August 2014.
2 H. Savage et al. The Mean Apnoea Hypopnea Index as a
Diagnostic Criterion For Sleep Disordered Breathing In Patients with
Heart Failure. ESC Congress 2014, abstract FP# P2758 – presented 31
August 2014.
3 Dickstein K et al. Eur J Heart Fail 2008;10:933-89. doi:
10.1016/j.ejheart.2008.08.005.
4 Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D,
Topfer V. Sleep-disordered breathing in patients with symptomatic heart
failure: a contemporary study of prevalence in and characteristics of
700 patients. Eur J Heart Fail. 2007;9:251–257. [PubMed]
5 Schulz R, Blau A, Börgel J, Duchna HW, Fietze I, Koper I,
Prenzel R, Schädlich S, Schmitt J, Tasci S, Andreas S. working group
Kreislauf und Schlaf of the German Sleep Society (DGSM) Sleep apnoea in
heart failure. Eur Respir J. 2007;29:1201–1205. [PubMed]
6 Javaheri. Basics of Sleep Apnoea and Heart Failure. Sleep
Apnoea and CV Disease – A CardioSource Clinical Community. Available
online at http://apnea.cardiosource.org/Basics/2013/02/Basics-of-Sleep-Apnea-and-Heart-Failure.aspx
(last accessed, August 2014).
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Source: ResMed
Media contacts
For further information or comment on this
analysis, SERVE-HF
or the importance of cardiologist recognition of
SDB,
please contact:
Tim Cockroft
RM Eclipse
+44
207 861 2805
+44 7957 325 583
tim@rmeclipse.com
or
Odile
Bigaignon
Cardiology Director, Europe
ResMed
+33
426 100 245
+33 6 26 38 55 58
Odile.Bigaignon@resmed.com