RT Journal Article
SR Electronic
T1 Cardiovascular event rates in the MOSAIC trial: 2-year follow-up data
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 950
OP 950
DO 10.1136/thoraxjnl-2013-204826
VO 69
IS 10
A1 C D Turnbull
A1 S E Craig
A1 M Kohler
A1 D Nicoll
A1 J Stradling
YR 2014
UL http://thorax.bmj.com/content/69/10/950.abstract
AB The Multicentre Obstructive Sleep Apnoea Intervention Cardiovascular (MOSAIC) trial investigated the effect of continuous positive airway pressure (CPAP) on both sleepiness and predicted cardiovascular risk over 6 months in minimally symptomatic patients with obstructive sleep apnoea. Although there was clear benefit in terms of Epworth Sleepiness Score, there was no improvement in blood pressure and predicted vascular risk score. In order to calculate the required size of future trials, with real vascular events as the endpoint, the rate of such events in this population is needed. 188 patients from the original trial were followed for 2 years. The overall number of new vascular events over the 2 years was 25, and all-cause mortality was 4. There was a weak statistically significant reduction in vascular events in the CPAP group (p=0.049). Large-scale randomised trials are needed to determine if CPAP causes a real reduction in vascular events in minimally symptomatic patients. Based on our figures, future trials of CPAP versus no treatment would need to randomise approximately 2540 patients to not miss a real reduction in vascular events and over 6000 for mortality.