TABLE VIII.B. 3.

Evidence for PAP use and mortality risk reduction

	Year	LOE	Study design	Study groups	Clinical end-point	Conclusion
Sanchez-de-la-Torre et al.1203	2020	1b	RCT	1264 patients hospitalized for acute coronary syndrome and AHI > 15 randomized to CPAP treatment plus usual care vs. usual care alone ISAACC study: Impact of sleep apnea syndrome in the evolution of acute coronary syndrome – effect of intervention with CPAP	Cardiovascular mortality and all-cause mortality	No significant benefit with CPAP therapy for cardiovascular mortality (hazard ratio 0.83) or all-cause mortality (hazard ratio 0.82), however, the mean adherence to CPAP therapy was only 2.78 h/night.
Patil et al.39	2019	1a, 2a	SR	4 RCTs comparing CPAP to no CPAP 9 non-randomized trials comparing PAP vs. control conditions	All-cause mortality	Meta-analysis of RCTs showed that CPAP therapy did not reduce all-cause mortality (risk ratio 0.96); however, there was variability in CPAP adherence. Meta-analysis of non-randomized trials demonstrated a clinically significant reduction in all-cause mortality (risk ratio 0.4).
Huang et al.1204	2015	1b	RCT	83 patients randomized to CPAP vs. no therapy	Severe cardiovascular and cerebrovascular events (including death)	There was a non-significant trend toward lower severe cardiovascular and cerebrovascular events with one death in the control group.