Hypoxic burden to guide CPAP treatment allocation in patients with obstructive sleep apnoea: a <i>post hoc</i> study of the ISAACC trial.

"Conflict of interest: M.Á. Martinez-Garcia received grants from VitalAire and Philips, Spain, and serves as a consultant for ResMed Inc., Australia, companies that develop products related to sleep apnoea. L. Messineo received a consultancy fee from Apnimed. A. Wellman works as a consultant for Apnimed, SomniFix and Nox, and has received grants from SomniFix and Sanofi; A. Wellman has a financial interest in Apnimed, a company developing pharmacological therapies for sleep apnoea. His interests were reviewed and are managed by Brigham and Women's Hospital and Partners HealthCare in accordance with their conflict of interest policies. S. Redline received grant support and consulting fees from Jazz Pharmaceuticals, and consulting fees from Apnimed and Lilly Pharma. S. Sands receives personal fees as a consultant for Nox Medical and Merck, outside the submitted work, and receives grant support from Apnimed and ProSomnus. F. Barbé received a research grant from ResMed Inc., Australia, a company that develops products related to sleep apnoea. A. Azarbarzin reports grant support from SomniFix and serves as a consultant for SomniFix, Respicardia, Eli Lilly and Apnimed. Apnimed is developing pharmacological treatments for obstructive sleep apnoea. A. Azarbarzin's interests were reviewed by Brigham and Women's Hospital and Mass General Brigham in accordance with their institutional policies. All other authors declare no competing interests."

"Conflict of interest: M.Á. Martinez-Garcia received grants from VitalAire and Philips, Spain, and serves as a consultant for ResMed Inc., Australia, companies that develop products related to sleep apnoea. L. Messineo received a consultancy fee from Apnimed. A. Wellman works as a consultant for Apnimed, SomniFix and Nox, and has received grants from SomniFix and Sanofi; A. Wellman has a financial interest in Apnimed, a company developing pharmacological therapies for sleep apnoea. His interests were reviewed and are managed by Brigham and Women's Hospital and Partners HealthCare in accordance with their conflict of interest policies. S. Redline received grant support and consulting fees from Jazz Pharmaceuticals, and consulting fees from Apnimed and Lilly Pharma. S. Sands receives personal fees as a consultant for Nox Medical and Merck, outside the submitted work, and receives grant support from Apnimed and ProSomnus. F. Barbé received a research grant from ResMed Inc., Australia, a company that develops products related to sleep apnoea. A. Azarbarzin reports grant support from SomniFix and serves as a consultant for SomniFix, Respicardia, Eli Lilly and Apnimed. Apnimed is developing pharmacological treatments for obstructive sleep apnoea. A. Azarbarzin's interests were reviewed by Brigham and Women's Hospital and Mass General Brigham in accordance with their institutional policies. All other authors declare no competing interests. Support statement: The ISAACC trial was funded by Instituto de Salud Carlos III (PI10/02763, PI10/02745, PI18/00449 and PI22/00636), co-funded by the European Union, Spanish Respiratory Society (SEPAR), Catalonian Cardiology Society, ResMed Ltd (Australia), EsteveTeijin (Spain), Oxigen Salud (Spain), and ALLER and CIBERES. The funding sources did not have any participation or decision in the study development. This research was also supported by the American Academy of Sleep Medicine Foundation (188-SR-17, SR-2217), American Heart Association (19CDA34660137) and NHLBI (R01HL153874 and R35HL135818). L. Pinilla has received financial support from the Ministry of Universities of Spain (Formación de Profesorado Universitario: FPU19/01555; Ayudas para Estancias Breves: EST22/00259), Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Fundació Catalana de Pneumologia (FUCAP), CIBERES and IRBLleida. M. Sánchez-de-la-Torre has received financial support from Ministerio de Ciencia e Innovación – Agencia Estatal de Investigación (Ramón y Cajal: RYC2019-027831-I). Funding information for this article has been deposited with the Crossref Funder Registry."

"This is a post hoc analysis of the ISAACC study (ClinicalTrials.gov: NCT01335087), a multicentre, open-label, parallel and prospective RCT []. A detailed description of the study aims and protocol, including inclusion and exclusion criteria, is outlined elsewhere []. Briefly, consecutive adult subjects admitted for acute coronary syndrome (ACS) to the coronary care unit or cardiology hospitalisation ward were eligible to participate in the study if they did not exhibit excessive daytime sleepiness, defined as Epworth Sleepiness Scale (ESS) ≤10. ACS was defined as the acute presentation of coronary disease with or without ST segment elevation infarction, unstable angina or type 1 myocardial infarction. Recruitment took place throughout 15 hospitals in Spain between 2011 and 2018, with the last end-of-study visit conducted in 2019. The clinical research ethics committee of each participating centre approved the trial protocol (approval number in the coordinating centre (University Hospital Arnau de Vilanova and Santa María, IRBLleida, Lleida, Spain): 2010/852) and every enrolled patient provided informed written consent to participate in the study."