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Atrial fibrillation is associated with severe sleep‐disordered breathing in patients with ischaemic stroke and transient ischaemic attack
Author(s) -
Shibazaki K.,
Kimura K.,
Uemura J.,
Sakai K.,
Fujii S.,
Sakamoto Y.,
Aoki J.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2012.03837.x
Subject(s) - medicine , atrial fibrillation , cardiology , stroke (engine) , ischaemic stroke , proportional hazards model , respiratory disturbance index , polysomnography , apnea , mechanical engineering , engineering
Background and purpose Sleep‐disordered breathing ( SDB ) is a risk factor for cerebrovascular disease. We investigated the frequency of SDB in J apanese patients with acute ischaemic stroke and transient ischaemic attack ( TIA ), as well as factors associated with SDB severity. Methods Between A pril 2010 and M arch 2011, we prospectively enrolled patients with ischaemic stroke and TIA within 24 h of onset to participate in a sleep study within 7 days of admission. We defined SDB as a respiratory disturbance index ( RDI ) (number of apnoeas or hypopnoeas 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. Results We 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 . Conclusion Most J apanese patients with acute ischaemic stroke and TIA had SDB , and AF was associated with SDB .