Recurrent Ischemic Stroke Risk Associated With Sleep Apnea
Sleep apnea is associated with an increased risk for recurrent ischemic stroke and mortality.
Sleep apnea is associated with risk for recurrent ischemic stroke and mortality, according to the findings of a population-based study presented at the 2018 International Stroke Conference in Los Angeles, California.
Researchers identified 842 participants in the Brain Attack Surveillance in Corpus Christi (BASIC) project who had an ischemic stroke between 2010 and 2015. The participant median age was 65 years and the median apnea-hypopnea index (AHI) was 14. A total of 47% of the patients were women, 58% were Mexican American, and 34% were non-Hispanic white. Sleep apnea was present in 63% of the patients, and was associated with male sex, Mexican American ethnicity, being insured, not smoking, and having diabetes, hypertension, lower educational status, and higher body mass index.
A total of 90 (10.7%) recurrent strokes and 125 (14.8%) deaths occurred during a median timeframe of 584 days, with a cumulative incidence of recurrence or death of 202 (24%). In both unadjusted and adjusted models, AHI was associated with the combined end point of recurrent stroke and death (hazard ratio 1.09 per 1 unit increase in AHI; 95% CI, 1.08-1.10 and hazard ratio 1.71; 95% CI, 1.16-2.54, respectively).
In addition, Mexican Americans had a higher risk for recurrent stroke and death following ischemic stroke compared with non-Hispanic whites.
“[Sleep apnea] may therefore represent an important modifiable risk factor for poor stroke outcomes and a target to reduce ethnic stroke disparities,” the researchers concluded.
Brown DL, Li C, Chervin R, et al. Sleep apnea is associated with the combined end point of recurrent stroke and post-stroke mortality. Presented at: International Stroke Conference. January 24-26, 2018; Los Angeles, CA. Abstract WMP59.