Pooled prevalences of obstructive sleep apnea and heart failure: a systematic review and meta-analysis

Wisarud Prechaporn; Phasu Hantrakul; Chetta Ngamjarus; Wattana Sukeepaisarnjaroen; Kittisak Sawanyawisuth; Sittichai Khamsai

doi:10.1007/s10741-024-10399-6

Pooled prevalences of obstructive sleep apnea and heart failure: a systematic review and meta-analysis

Heart Fail Rev. 2024 May 9. doi: 10.1007/s10741-024-10399-6. Online ahead of print.

Authors

Wisarud Prechaporn¹, Phasu Hantrakul¹, Chetta Ngamjarus², Wattana Sukeepaisarnjaroen¹, Kittisak Sawanyawisuth³, Sittichai Khamsai⁴

Affiliations

¹ Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
² Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
³ Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. kittisak@kku.ac.th.
⁴ Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. sittikh@kku.ac.th.

PMID: 38722388
DOI: 10.1007/s10741-024-10399-6

Abstract

Obstructive sleep apnea (OSA) is a disease with intermittent hypoxemia during sleep. It has been shown that OSA is related to several cardiovascular diseases including heart failure. Both OSA and heart failure have a close association bidirectionally. This study aimed to estimate the pooled prevalence of OSA in patients with heart failure as well as pooled prevalence of heart failure in patients with OSA. This was a systematic review with a meta-analysis. The inclusion criteria were observational or epidemiological studies conducted in adult patients with heart failure to evaluate the prevalence of OSA and patients with OSA to evaluate the prevalence of heart failure. The outcomes of this study were prevalence of OSA in patients with heart failure and prevalence of heart failure in patients with OSA. Four databases were used for systematic searching including PubMed, Science Direct, Scopus, and CINAHL Plus. Manual searches for related studies were also conducted. Proportion meta-analyses using a random-effects model were conducted to identify pooled proportion (prevalence) of heart failure in patients with OSA and vice versa. Among 3,941 articles from the four databases met the study criteria. Thirty-three studies showed the prevalence of OSA in patients with heart failure, while thirteen studies presented the prevalence of heart failure in patients with OSA. The prevalence of OSA in patients with heart failure was 38.4% (95% CI 31.9 to 45.2; I² of 96.1%). Using a diagnostic criterion of OSA of more than 10 events/hr had the highest prevalence of OSA in patients with heart failure at 53.4% (95% CI 42.0 to 64.5). The highest prevalence of OSA in patients with heart failure was 60.1% (95% CI 51.4 to 68.3) in a report from India. The pooled prevalence of heart failure in patients with OSA was 12.8% (95% CI 8.1 to 19.5; I² of 94.6%). The prevalence in Romania was highest at 22.6% (95% CI 20.4 to 24.9). The pooled prevalence of OSA in patients with heart failure was higher than the pooled prevalence of heart failure in patients with OSA. The pooled prevalence rates of these associations varied among the diagnostic criteria of OSA and countries.

Keywords: Heart failure; Obstructive sleep apnea; Prevalence Systematic review.

Publication types

Review

Grants and funding

SY67002/Khon Kaen University