Evidence map›Paper›PMID 42110829›Full record

ReviewJournal of the Saudi Heart Association2026

Role of Continuous Positive Airway Pressure in the Prevention of Cardiovascular Events in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Ahmad Alilo, Maryam Altaher, Mohamed Almuzainy, Sami Alsalem, Mohamed Dawdi

Abstract readReview
In one paragraph

Review in Journal of the Saudi Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Saif Almuzainy *College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Mohamed Lemine *College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Rayan Aljubeh *College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Ahmad AliloCollege of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Maryam AltaherCollege of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Mohamed AlmuzainyCollege of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Sami AlsalemCollege of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Mohamed DawdiEmergency Department, University Hospital Sharjah, Sharjah, United Arab Emirates.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Obstructive sleep apnea (OSA) is prevalent among patients with cardiovascular disease and is associated with increased risk of major adverse cardiovascular events (MACE). Continuous positive airway pressure (CPAP) is the standard treatment for OSA, but its impact on cardiovascular outcomes remains uncertain, particularly in randomized controlled trials (RCTs). Objectives: To evaluate the effect of CPAP therapy on cardiovascular outcomes in patients with OSA, and to explore the influence of adherence on treatment efficacy. Methods: We conducted a systematic review and meta-analysis of RCTs comparing CPAP with placebo or usual care in adults with OSA. Databases including PubMed, Scopus, Ovid, and CINAHL were searched from inception to December 2024. Primary outcome was MACE; secondary outcomes included cardiovascular mortality, all-cause mortality, myocardial infarction, stroke, angina, heart failure, and new-onset atrial fibrillation. Subgroup analyses were performed based on CPAP adherence (≥4 hours/night vs <4 hours/night). Risk ratios (RRs) with 95 % confidence intervals (CIs) were pooled using fixed-effects model. Results: Eleven RCTs comprising 6139 participants were included. Overall, CPAP did not significantly reduce MACE (RR = 1.00; 95 % CI: 0.87-1.14) or secondary cardiovascular outcomes. However, in patients adherent to CPAP (≥4 hours/night), MACE was significantly reduced (RR = 0.71; 95 % CI: 0.52-0.97), and cardiovascular mortality decreased (RR = 0.36; 95 % CI: 0.14-0.91). Subgroup analyses revealed no significant benefits in non-adherent patients. Heterogeneity was low for most outcomes. Conclusion: CPAP therapy does not significantly reduce overall cardiovascular risk in OSA patients, except among adherent individuals. These findings underscore adherence as a critical determinant of CPAP's cardiovascular efficacy. Future trials should prioritize strategies to optimize adherence to fully evaluate CPAP's cardioprotective potential.

Indexed as

Cardiovascular outcomesContinuous airway pressureMajor adverse cardiovascular eventsObstructive sleep apnea

Identifiers

PMID42110829
PMCPMC13155447

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.