0976 Hypoglossal Nerve Stimulation and Maxillomandibular Advancement: A Comparison of Cardiovascular Outcomes in OSA

Abstract Introduction Treatment of obstructive sleep apnea (OSA) with maxillomandibular advancement (MMA) surgery has been found to improve cardiovascular outcomes in patients. Hypoglossal nerve stimulation (HNS) is a newer, less invasive procedure to treat OSA, with questions on cardiovascular outcomes remaining unanswered. This study evaluates whether HNS is non-inferior to MMA in preventing major adverse cardiovascular events (MACE) among patients with moderate-to-severe OSA. Methods This large-scale retrospective cohort study utilized the TriNetX Global Collaborative Network, analyzing anonymized electronic health records from approximately 185 million patients across 152 healthcare organizations. A total of 1,266 propensity score–matched OSA patients who underwent either HNS or MMA was included. Cohorts were observed at 1, 3, and 5 years post-treatment for the incidence of MACE outcomes (atrial fibrillation and flutter, cerebral infarction, acute myocardial infarction, transient cerebral ischemic attacks and related syndromes, and heart failure). Incidence of new-onset hypertension diagnosis and new hypertensive medication prescription also was analyzed. Results There was no significant difference in total MACE and hypertension outcomes between patients who received HNS compared to those who received MMA. However, cerebral infarction incidence was significantly higher in the HNS group at 3 and 5 years, while new hypertensive prescriptions were more frequent in the MMA group at 1 year. Conclusion These results suggest that there is no difference in cardiovascular outcomes in patients after receiving HNS or MMA. This may have implications for physician decision-making and treatment of moderate-to-severe OSA. Future studies with longer follow-up are needed to clarify whether these outcomes remain consistent and to assess further whether there is a difference between these procedures in other outcomes related to OSA between these procedures. Support (if any)