The prevalent co-morbidity of coronary artery disease (CAD) and obstructive sleep apnea (OSA) has attracted great interest. However, effects of continuous positive airway pressure (CPAP) in patients with OSA and CAD for cardiovascular outcomes and deaths are still controversial. Usage of CPAP among patients with CAD and OSA could decrease the risk of cardiovascular events and death in adults. PubMed, EMBASE, Web of science, and Cochrane Library were systematically searched. Studies that described association of CPAP treatment with cardiovascular events in CAD and OSA patients were included. The main outcome was the major adverse cardiovascular events (MACE), including all-cause death, cardiovascular death, myocardial infarction (MI), stroke, and repeat revascularization. Summary relative risks (risk ratios [RRs]) and 95% confidence intervals (CIs) of outcomes were pooled and heterogeneity was assessed with the I² statistic. Nine studies enrolling 2590 participants with OSA and CAD were included and extracted data. There was significant association of CPAP with reduced risk of MACE (RR, 0.73, 95% CI [0.55, 0.96]), particularly among those with AHI less than 30 events/h (RR, 0.43, 95% CI [0.22, 0.84]). Similarly, the same result was found in all-cause death (RR, 0.66, 95% CI, [0.46, 0.94]) and cardiovascular death (RR, 0.495, 95% CI [0.292, 0.838]). Our data suggested that CPAP usage, compared to usual care, was associated with reduced risks of cardiovascular outcomes or death in patients with OSA and CAD, particularly in the subgroup with AHI less than 30 events/h, which still needs further studies to confirm.

中文翻译：

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持续气道正压通气治疗对冠状动脉疾病和阻塞性睡眠呼吸暂停患者有益吗？系统评价和荟萃分析

冠状动脉疾病 (CAD) 和阻塞性睡眠呼吸暂停 (OSA) 的普遍共病引起了极大的兴趣。然而，持续气道正压通气 (CPAP) 对 OSA 和 CAD 患者心血管结局和死亡的影响仍存在争议。在 CAD 和 OSA 患者中使用 CPAP 可以降低成人心血管事件和死亡的风险。系统地检索了 PubMed、EMBASE、Web of science 和 Cochrane Library。包括描述 CPAP 治疗与 CAD 和 OSA 患者心血管事件关联的研究。主要结果是主要不良心血管事件 (MACE)，包括全因死亡、心血管死亡、心肌梗死 (MI)、中风和再次血运重建。²统计。九项研究纳入了 2590 名 OSA 和 CAD 参与者并提取了数据。CPAP 与 MACE 风险降低显着相关（RR, 0.73, 95% CI [0.55, 0.96]），特别是在 AHI 小于 30 个事件/小时的患者中（RR, 0.43, 95% CI [0.22, 0.84]） ）。同样，在全因死亡 (RR, 0.66, 95% CI, [0.46, 0.94]) 和心血管死亡 (RR, 0.495, 95% CI [0.292, 0.838]) 中也发现了相同的结果。我们的数据表明，与常规护理相比，使用 CPAP 与 OSA 和 CAD 患者的心血管结局或死亡风险降低相关，尤其是在 AHI 低于 30 个事件/小时的亚组中，这仍需要进一步研究来证实。