OSA and CV Outcomes in Patients With High Risk AF

NCT ID: NCT04005508

Last Updated: 2024-06-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

1365 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-07-01

Study Completion Date

2028-06-30

Brief Summary

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The POACH study is part of the Cardiosleep research program. It is a prospective, observational, multicentre study conducted in Singapore. The recruitment target is 1365 patients.

Eligible patients with AF and high cardiovascular risk will be recruited for a home-based sleep study using a FDA-approved portable device. The patients will be divided into 2 groups based on the presence or absence of OSA using apnoea-hypopnoea index ≥ 15 events/hour. The AF will be treated as per local standard practice. Participation in the POACH study will not affect the management of AF. Follow-up will be conducted every 6 months until the median follow-up duration has reached 2 years. The primary endpoint is a four-component composite of all-cause mortality, myocardial infarction, stroke and heart failure hospitalisation.

Antecubital venous blood samples will be taken from the patients in the morning after the sleep study for targeted mass spectrometry which will measure 83 circulating metabolites. Sparse Principal Component Analysis will be used for data reduction. Identification of distinct associations between metabolic perturbations and OSA will be performed.

Detailed Description

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The overarching objective of the POACH study is to determine the impact of obstructive sleep apnoea (OSA) on cardiovascular outcomes in patients with atrial fibrillation (AF).

AF is the most prevalent sustained arrhythmia. While OSA often co-exists with AF, current management of AF does not take OSA status into consideration. This is partly due to the lack of data on whether OSA is independently associated with cardiovascular events in patients with AF. Besides, metabolomics is an emerging field of 'omics' research focusing on profiling and quantifying low-molecular weight components.

The POACH study is part of the Cardiosleep research program. It is a prospective, observational, multicentre study conducted in Singapore. The recruitment target is 1365 patients.

Eligible patients with AF and high cardiovascular risk will be recruited for a home-based sleep study using a FDA-approved portable device. The patients will be divided into 2 groups based on the presence or absence of OSA using apnoea-hypopnoea index ≥ 15 events/hour. The AF will be treated as per local standard practice. Follow-up will be conducted every 6 months until the median follow-up duration has reached 2 years. The primary endpoint is a four-component composite of all-cause mortality, myocardial infarction, stroke and heart failure hospitalisation. Antecubital venous blood samples will be taken from the patients in the morning after the sleep study for targeted mass spectrometry which will measure 83 circulating metabolites. Sparse Principal Component Analysis will be used for data reduction. Identification of distinct associations between metabolic perturbations and OSA will be performed.

Results of the POACH study will likely impact the care of patients with AF.

Conditions

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Atrial Fibrillation Obstructive Sleep Apnea

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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OSA (Watch PAT AHI >/= 15 events per hour)

Patients found to have OSA by an overnight sleep study

Overnight sleep study

Intervention Type DIAGNOSTIC_TEST

The patients will undergo an overnight sleep study using Watch-PAT sleep study device

Non-OSA (Watch PAT AHI < 15 events per hour)

Patients found NOT to have OSA by an overnight sleep study

Overnight sleep study

Intervention Type DIAGNOSTIC_TEST

The patients will undergo an overnight sleep study using Watch-PAT sleep study device

Interventions

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Overnight sleep study

The patients will undergo an overnight sleep study using Watch-PAT sleep study device

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Age 22 or above
2. Known AF, including paroxysmal, persistent or permanent AF
3. High cardiovascular risk, defined as one or more of the following:

* hypertension
* diabetes mellitus
* stroke
* significant coronary artery disease (at least one stenosis of \>50% diameter in at least one major epicardial artery based on CT or conventional coronary angiography, positive stress test \[treadmill, myocardial perfusion scan, or stress echocardiography\], previous percutaneous coronary intervention, or previous coronary artery bypass surgery)
* chronic kidney disease (excluding polycystic kidney disease) with an estimated glomerular filtration rate of \<60 ml/min/1.73m2,
* 10-year risk of cardiovascular disease of 15% or greater on the basis of the Framingham risk score, or
* age of 75 years or older

Exclusion Criteria

1. Known OSA on regular CPAP treatment
2. Valvular AF (moderate/severe mitral stenosis or mechanical heart valve)
3. Permanent pacemaker implantation
4. Life expectancy less than 1 year based on concomitant medical conditions
5. Unable to give research consent
6. Pregnant or lactating women
Minimum Eligible Age

22 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ng Teng Fong General Hospital

OTHER

Sponsor Role collaborator

National University Hospital, Singapore

OTHER

Sponsor Role collaborator

Singapore General Hospital

OTHER

Sponsor Role collaborator

National University of Singapore

OTHER

Sponsor Role lead

Responsible Party

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Chi-Hang Lee

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Chi-Hang R Lee, MD

Role: PRINCIPAL_INVESTIGATOR

National University of Singapore

Locations

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Chi-Hang Lee

Singapore, , Singapore

Site Status RECRUITING

Countries

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Singapore

Central Contacts

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Shalini Lobo, BSc

Role: CONTACT

67795555 ext. 2493

Junping Liu, BSc

Role: CONTACT

67795555 ext. 2493

Facility Contacts

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Lee CH Ronald, MD

Role: primary

67722493 ext. 22493

Other Identifiers

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POACH

Identifier Type: -

Identifier Source: org_study_id

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