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Atrial fibrillation is associated with severe sleep-disordered breathing in patients with ischaemic stroke and transient ischaemic attack
European Journal of Neurology, 08/17/2012
Clinical Article
Shibazaki K et al. – Most Japanese patients with acute ischaemic stroke and transient ischaemic attack (TIA) had Sleep–disordered breathing (SDB), and atrial fibrillation (AF) was associated with SDB.
Methods- Between April 2010 and March 2011, the authors prospectively enrolled patients with ischaemic stroke and TIA within 24 h of onset to participate in a sleep study within 7 days of admission.
- They defined SDB as a respiratory disturbance index (RDI: apneas or hypopneas per hour) of ≥5.
- Patients were assigned to groups based on RDI values of ≥30 (severe) and <30 (absent or not severe).
- The frequency of SDB and factors associated with severity were investigated using multivariate regression analysis.
- They enrolled 150 patients amongst whom 126 (84%) had SDB.
- The frequencies of SDB were 21 (75%) patients with TIA, 105 (86%) with ischaemic stroke, 8/10 (80%) with large artery atherosclerosis, 14/14 (100%) with small vessel occlusion, 37/41 (90%) with cardioembolism and 46/57 (81%) with other causes of stroke/undetermined.
- Severe SDB was evident in 44 (29%) patients.
- The frequency of males (75% vs. 56%, P=0.027), atrial fibrillation (AF) (39% vs. 23%, P=0.045), higher body mass index (23.8 ± 3.8 vs. 22.3 ± 3.8, P=0.043) and a larger neck circumference (37.8 ± 4.3 vs. 35.8 ± 4.2, P= 0.012) was significantly higher in the group with severe SDB.
- Multivariate regression analysis found that AF (OR, 2.4; 95%CI, 1.079-5.836, P = 0.0359) was independently associated with severe SDB.