Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial.
The aim of the present study was to assess the impact of nasal continuous positive airway pressure (nCPAP) in ischaemic stroke patients followed for 2 yrs. Stroke patients with an apnoea-hypopnoea index ≥ 20 events·h⁻¹ were randomised to early nCPAP (n = 71; 3-6 days after stroke onset) or conventional treatment (n = 69). The Barthel Index, Canadian Scale, Rankin Scale and Short Form-36 were measured at baseline, and at 1, 3, 12 and 24 months. The percentage of patients with neurological improvement 1 month after stroke was significantly higher in the nCPAP group (Rankin scale 90.9 versus 56.3% (p < 0.01); Canadian scale 88.2 versus 72.7% (p < 0.05)). The mean time until the appearance of cardiovascular events was longer in the nCPAP group (14.9 versus 7.9 months; p = 0.044), although cardiovascular event-free survival after 24 months was similar in both groups. The cardiovascular mortality rate was 0% in the nCPAP group and 4.3% in the control group (p = 0.161). Early use of nCPAP seems to accelerate neurological recovery and to delay the appearance of cardiovascular events, although an improvement in patients' survival or quality of life was not shown.
Parra
O
O
Servicio de Neumología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Spain. oparra@ub.edu
Sánchez-Armengol
A
A
Bonnin
M
M
Arboix
A
A
Campos-Rodríguez
F
F
Pérez-Ronchel
J
J
Durán-Cantolla
J
J
de la Torre
G
G
González Marcos
J R
JR
de la Peña
M
M
Carmen Jiménez
M
M
Masa
F
F
Casado
I
I
Luz Alonso
M
M
Macarrón
J L
JL
D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality; D011788:Quality of Life; D012008:Recurrence; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D020521:Stroke / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome