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Associations between Cardioembolic Stroke and Obstructive Sleep Apnea
Melissa C Lipford1,2, Kelly D Flemming1, Andrew D Calvin3
1Department of Neurology, Rochester, MN.
Sleep
|August 4, 2015
Summary
Obstructive sleep apnea (OSA) is strongly linked to cardioembolic (CE) strokes, even after accounting for atrial fibrillation (AF). This suggests OSA may independently increase CE stroke risk or indicate undiagnosed AF.
Area of Science:
- Neurology
- Sleep Medicine
- Cardiology
Background:
- Obstructive sleep apnea (OSA) is a common condition associated with cardiovascular risks.
- Understanding the specific mechanisms linking OSA to ischemic stroke is crucial for prevention.
Purpose of the Study:
- To investigate the etiological differences in ischemic stroke between patients with and without obstructive sleep apnea (OSA).
- To determine if OSA independently contributes to cardioembolic (CE) stroke risk.
Main Methods:
- Retrospective case-control study at an academic tertiary referral center.
- Identified ischemic stroke patients who underwent polysomnography.
- Classified stroke subtypes and compared cardiovascular risk factors, neuroimaging, and echocardiographic data between OSA cases and controls.
Main Results:
- Cardioembolic (CE) strokes were significantly more prevalent in patients with OSA (72%) compared to controls (33%).
- Atrial fibrillation (AF) was more frequent in OSA cases (59% vs. 24%).
- The association between OSA and CE stroke remained significant even after adjusting for AF (OR 4.5, P=0.03).
Conclusions:
- A strong association exists between obstructive sleep apnea (OSA) and cardioembolic (CE) stroke.
- In OSA patients with cryptogenic stroke, a high suspicion for CE etiology is warranted, potentially prompting further diagnostic studies for conditions like paroxysmal AF.
- OSA may increase CE stroke risk through mechanisms independent of AF or via a higher prevalence of undiagnosed AF.
Keywords:
atrial fibrillationcardioembolismcryptogenic strokesleep disordered breathingstroke preventionMore Related Videos
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