Multidisciplinary therapy comparable to standard treatment for cutting cardiovascular markers in ACS

Screening for obstructive sleep apnoea and multifaceted treatment during the subacute phase of acute coronary syndrome (ACS) does not lower cardiovascular marker levels more than standard therapy, a recent study has found.

Researchers randomly assigned 159 patients to receive either sleep-study guided multidisciplinary therapy (SGMT; n=70; mean age, 55.6±9.0 years; 91.4 percent male) or standard therapy (n=89; mean age, 54.2±7.4 years; 87.6 percent male). The primary study endpoint was the change in plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels after 7 months.

NT-proBNP decreased with time in both treatment arms. No significant between-group differences were reported at baseline (579±1,117 vs 611±899 pg/dL; p=0.851) and after 4 (115±222 vs 114±226 pg/dL; p=0.990) and 7 (90±167 vs 93±174 pg/dL; p=0.996) months of follow-up.

Similarly, the magnitudes of change from baseline were comparable between groups after 4 (–464 vs –497 pg/dL; p=0.792) and 7 (–489 vs –518 pg/dL; p=0.726) months.

Levels of plasma suppression of tumorigenicity 2 and high-sensitivity C-reactive protein likewise were not significantly different between the two groups.

These resulted in similar risks. At the 7-month follow-up, the estimated likelihood of developing fatal cardiovascular disease within 10 years was 2.1±1.8 percent in the SGMT group and 2.0±2.4 percent in the controls (p=0.176). At this time point, major adverse cardiac and cerebrovascular events also occurred with comparable frequencies between groups.