Luong TV, Hoang TA, Tran DH, Pham NNK, Nguyen HC, Le NHN, Dang HNN. Continuous positive airway pressure therapy for patients with obstructive sleep apnea and coronary artery disease. World J Cardiol 2025; 17(10): 107750 [DOI: 10.4330/wjc.v17.i10.107750]
Corresponding Author of This Article
Hai Nguyen Ngoc Dang, MD, Lecturer, Researcher, Faculty of Medicine, Duy Tan University, 254 Nguyen Van Linh, Da Nang 550000, Viet Nam. ngochai123dc@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Oct 26, 2025; 17(10): 107750 Published online Oct 26, 2025. doi: 10.4330/wjc.v17.i10.107750
Continuous positive airway pressure therapy for patients with obstructive sleep apnea and coronary artery disease
Thang Viet Luong, Tien Anh Hoang, Duong Hung Tran, Nguyen Nguyen Khoi Pham, Huy Cong Nguyen, Nam Hoang Nhat Le, Hai Nguyen Ngoc Dang
Thang Viet Luong, Tien Anh Hoang, Duong Hung Tran, Nguyen Nguyen Khoi Pham, University of Medicine and Pharmacy, Hue University, Hue 530000, Viet Nam
Thang Viet Luong, Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia
Tien Anh Hoang, Vietnam Society of Sleep Medicine, Hanoi 100000, Vietnam
Huy Cong Nguyen, Department of Internal Medicine, Phuc Hung Private General Hospital, Quang Ngai 570000, Viet Nam
Nam Hoang Nhat Le, Department of Emergency, Tam Anh General Hospital, Ho Chi Minh City 700000, Viet Nam
Hai Nguyen Ngoc Dang, Faculty of Medicine, Duy Tan University, Da Nang 550000, Viet Nam
Co-first authors: Thang Viet Luong and Tien Anh Hoang.
Author contributions: Luong TV and Hoang TA were responsible for conceptualizing the study and writing the original draft of the manuscript; Dang HNN is designated as the corresponding author owing to his specific contributions; Luong TV, Hoang TA, Tran DH, Pham NNK, Nguyen HC, Le NHN, Dang HNN contributed to the writing, reviewing, editing, and drafting of the manuscript and have read and approved the final version; as co-first authors, Luong TV led the data analysis and interpretation, whereas Hoang TA coordinated the research methodology and data collection, with each making essential contributions to the study’s completion.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai Nguyen Ngoc Dang, MD, Lecturer, Researcher, Faculty of Medicine, Duy Tan University, 254 Nguyen Van Linh, Da Nang 550000, Viet Nam. ngochai123dc@gmail.com
Received: March 31, 2025 Revised: June 7, 2025 Accepted: September 3, 2025 Published online: October 26, 2025 Processing time: 210 Days and 5.4 Hours
Abstract
Obstructive sleep apnea (OSA) and coronary artery disease (CAD) frequently coexist, forming a bidirectional pathophysiological loop that amplifies cardiovascular risk. Intermittent hypoxemia in OSA patients promotes endothelial dysfunction, systemic inflammation, oxidative stress, and sympathetic activation, thereby accelerating atherogenesis, whereas myocardial ischemia and ventricular dysfunction in CAD patients can further destabilize upper-airway patency and exacerbate OSA. Continuous positive airway pressure (CPAP) is the standard therapy for OSA and reliably restores sleep architecture; however, large randomized trials have reported inconsistent effects on major adverse cardiovascular events, particularly in patients with established CAD. This mini review synthesizes contemporary data on CPAP across diverse OSA–CAD clinical scenarios, delineates patient phenotypes most likely to achieve cardiovascular benefit and identifies contexts in which CPAP provides limited protection. On the basis of these findings, we propose pragmatic recommendations for patient selection, adherence monitoring and optimization of CPAP therapy and highlight key research priorities, including extended follow-up, adherence-enhancing strategies and multimodal interventions. Clarifying the circumstances under which CPAP is cardioprotective will enable more precise management of patients with OSA, with or without concomitant CAD.
Core Tip: Obstructive sleep apnea and coronary artery disease often cooccur, each worsening the other. Continuous positive airway pressure (CPAP) improves obstructive sleep symptoms, but large trials have shown mixed cardiovascular benefits. This review highlights patient profiles most likely to benefit from CPAP and offers guidance for integrating CPAP with lifestyle and medical therapy to optimize outcomes.
