Evaluation of Ischemic Stroke and Risk Factors of Atrial Fibrillation in Patients with Obstructive Sleep Apnea Syndrome

Abstract

Objective: Obstructive sleep apnea syndrome (OSAS), a sleep-related breathing disorder, is characterized by apnea and hypoapnea. In patients with OSAS, ischemic stroke may have various causes such as large-vessel atherosclerosis and cardioembolism. OSAS is one of the risk factors of atherosclerosis, and it is thought to increase the risk of ischemic stroke by triggering atherosclerosis. Many studies have shown the relationship between OSAS and cardioembolic stroke. Ischemic stroke is a heterogeneous group of diseases caused by many complex mechanisms and may show ethnic and racial differences. This study aimed to determine the etiology and risk factors of ischemic stroke in the patient group diagnosed with OSAS in our population.

Materials and Methods: A total of 343 patients were retrospectively screened to determine the prevalence and risk factors of ischemic stroke in patients with obstructive sleep apnea in the sleep laboratory of the Department of Neurology, Faculty of Medicine, Uludag University, between 2015 and 2020.

Results: The study included 38 (11%) patients who were diagnosed with ischemic stroke. When patients with and without ischemic stroke were compared according to clinical, demographic, radiological, and polysomnographic data, a significant relationship was found in age, atrial fibrillation (AF), heart failure, hypertension, coronary artery disease, diabetes mellitus, smoking, and non-rapid eye movement 1. According to the binary logistic regression analysis, the variable most significantly related with ischemic stroke was AF. A significant relationship was found between OSAS severity and AF.

Conclusion: OSAS is a treatable sleep disorder that causes cardiovascular morbidity. OSAS is an important risk factor for the development and recurrence of AF. In this study, AF is the most important variable related to ischemic stroke in patients with OSAS, and it is associated with the severity of OSAS. Thus, patients with OSAS must be evaluated for AF to prevent ischemic stroke.

The study was approved by the Clinical Research Ethics Committee of Uludag University Faculty of Medicine (dated 09.03.2021 and numbered 2011-KAEK26/211, decision no: 2021-5/12).

Retrospective study.

Externally peer-reviewed.

Surgical and Medical Practices: Y.D., A.B.D., Concept: Y.D., A.B.D., Design: Y.D., A.B.D., Data Collection or Processing: Y.D., A.B.D., Analysis or Interpretation: Y.D., A.B.D., Literature Search: Y.D., A.B.D., Writing: Y.D., A.B.D.

No conflict of interest was declared by the authors.

The authors declared that this study received no financial support.