Association of obstructive sleep apnea and stenotic artery disease in ischemic stroke patients.
OBJECTIVE
Obstructive sleep apnea (OSA) is suspected to be an independent risk factor for atherosclerotic artery disease. The aim of this hospital-based case-control study was to assess the association between OSA and extracranial artery disease (EAD) as well as peripheral artery disease (PAD) in stroke survivors adjusting for potential confounders.


METHODS
Out of 395 stroke survivors in reconvalescent phase, 235 (male 165, female 70, mean age 64.3 years, standard deviation 10.8 years) were retrospectively examined for the presence of OSA as well as EAD. Statistical analyses were then performed to detect correlations between the presence of medium to high degree artery disease (extracranial stenosis equal or higher than 50%: n=67) and the presence of severe OSA (n=58). Adjustments were made for sex, age, Barthel index and concomitant risk factors as well as body mass index and presence of dysarthria or dysphagia. Additionally, the presence of PAD (Fontaine IIa and higher: n=20) was retrospectively examined in 240 out of 395 patients.


RESULTS
Severe OSA was associated independently with EAD (OR=2.0, 95%CI 1.0-4.1) and with PAD (OR=6.7, 95%CI 2.1-21.0). EAD additionally showed a stronger association with hypertension and hyperlipidemia. PAD additionally showed a strong association with smoking.


CONCLUSIONS
Our results support the hypothesis that OSA is associated with atherosclerosis and may contribute to ischemic stroke and PAD.
Nachtmann
Andreas
A
Neurologische Abteilung, Fachklinik Rhein-Ruhr, Auf der Rötsch 2, D-45219, Essen-Kettwig, Germany. dr.nachtmann@frr.de
Stang
Andreas
A
Wang
You-Ming
YM
Wondzinski
Elke
E
Thilmann
Alfred F
AF
D000368:Aged; D001161:Arteriosclerosis / Q000209:etiology; D002545:Brain Ischemia / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D020521:Stroke / Q000209:etiology*; D018616:Ultrasonography, Doppler, Duplex