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Sleep Apnea and Heart Failure in HIV

Clin Infect Dis; ePub 2018 Apr 19; Alvi, et al

Among patients with both heart failure (HF) and sleep apnea (SA), apnea severity was positively associated with adverse HF outcomes, while continuous positive airway pressure (CPAP) use conferred protection. Researchers conducted a single center study of persons living with HIV (PLHIV) admitted with heart failure with reduced ejection fraction (HFrEF) and analyzed the relationship of SA with 30-day HF hospital readmission rate, cardiovascular (CV) and all-cause mortality. They also assessed whether SA severity, CPAP use, and duration influenced HF outcomes. Among the findings:

  • 1,124 individuals were admitted with HFrEF (15% were PLHIV, 92% were on antiretroviral therapy).
  • SA was noted in 28% of PLHIV and 26% of uninfected controls.
  • Compared to uninfected controls with HFrEF and SA, PLHIV with HFrEF and SA had a lower body mass index, lower left ventricular ejection fraction (LVEF), a higher pulmonary artery systolic pressure (PASP), were more likely to have obstructive rather than central SA, and had higher rates of CPAP use.
  • PASP, low CD4 count, high viral load (VL), and SA parameters were predictors of 30-day HF readmission rate.
  • Each 1-hour increase in CAPA use was associated with a 14% decreased risk of 30-day HF readmission among PLHIV.

Citation:

Alvi RM, Tariq N, Malhotra A, et al. Sleep apnea and heart failure with a reduced ejection fraction among persons living with HIV. [Published online ahead of print April 19, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy216.

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