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Sleep apnea and recurrent heart failure hospitalizations after coronary artery bypass grafting

In this analysis of patients who underwent a nonemergent CABG, at a mean follow-up of 3.3 years approximately 10% of the patients had at least one episode of heart failure hospitalization. Among those patients, a subgroup of 37% of patients had recurrent events that accounted for two-thirds of the total 179 heart failure hospitalization events. Using four robust statistical methods, we found that patients with sleep apnea had a 1.6- to 1.8-fold increased risk of recurrent heart failure hospitalization, even after adjustment for differences in baseline demographic and clinical characteristics.

Heart failure hospitalization is burdensome and costly. In 2014, there were approximately 1.1 million emergency department visits, 980,000 hospitalizations, and 84,000 deaths directly attributable to heart failure in the United States. The total estimated cost was over $11 billion. Due to the limited effectiveness of stents,25,26 CABG is still widely performed. In patients discharged after a CABG, heart failure is the most common cause

of unscheduled hospitalization. 6 Thus, identifying patients at high risk has important implications for preventive efforts aimed at reducing the burden of post-CABG heart failure hospitalizations for both patients and society.

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