0541 Impact of Sleep Apnea Treatment on Cardiometabolic Parameters in a Large National Multi-Center Alliance Registry

Abstract Introduction There is paucity of real-world data regarding the association of Sleep Apnea (SA) treatment and cardiometabolic parameters. We examined the association of SA subgroup (CPAP vs. non-CPAP users) and cardiometabolic factors in the Cardiometabolic Center Alliance multi-center registry. Methods Out of 1575 patients, baseline characteristics of 683 patients with SA stratified by CPAP use were compared using Student’s t-tests/Wilcoxon rank-sum test for continuous variables and chi-square/Fisher’s exact tests for categorical variables. Logistic regression model was used to assess the association of CPAP-use and cardiometabolic factors (Hb A1c, systolic blood pressure and diastolic blood pressure (SBP and SDB mmHg)), Triglycerides (TG) and BMI in unadjusted (Model 1) and after adjusting for age, sex, ethnicity, race, BMI (Model 2) and cardiac co-morbidities, medications, and medication adherence (Model 3). Results Overall, median (IQR) age was 65 years (58.0-71.0). 683 (43 %) had sleep apnea, and of those 447 (65%) were CPAP-users. Median age of CPAP-users compared to non-users was 66 years (60-71) vs, 63 years (55.5-71), and they were more likely to be male (275 (61.5%) vs. 112 (52.8%)), and white (398 (89%) vs. 163 (76.9%) (all p < 0.05). Among CPAP users HbA1c, SBP, and DBP were 7.2% ± 1.5%, 128.2 ± 18.2, 72.9 ± 11.5; in non-CPAP users the corresponding values were 7.6% ± 1.9% (p=0.002), 131.1 ± 19.4 (p = 0.064), 76.0 ± 12.1 (p =0.002) respectively. Logistic regression showed that CPAP-use was associated with lower HbA1c (-0.31% (95% CI -0.59%, -0.04%), p =0.025) in Model 2 but not in Model 3 (-0.19% (95% CI -0.46%,0.08%), p=0.165). CPAP use was associated with lower SBP (-3.99 (95% CI -7.18, -0.8), p =0.014) and DBP (-2.52 (95% CI -4.45, -0.6), p=0.010) even after adjusting for multiple confounders in Model 3. Higher TG were observed (23.02 mg/dL (95% CI 1.03,45.01), p=0.04) in CPAP-users compared to non-CPAP users (Model 2). CPAP-users compared to non-users had higher BMI (1.14 (95% Cl 0.17, 2.65) p=0.026) Model 3. Conclusion In this multi-center registry of patients with cardiometabolic disease, sleep apnea was common, and CPAP use was associated with better control of several key risk factors. Support (if any)