Screening for atrial fibrillation in patients with obstructive sleep apnoea to reduce ischaemic strokes.
Obstructive sleep apnoea is an independent risk factor for stroke. A number of different mechanisms have been identified which link OSA and stroke including hypertension and oxidative stress. Atrial fibrillation (AF) is likely to play a role in the development of stroke in patients with OSA. Indeed, patients with OSA have a higher incidence of AF than the general population. Given the higher constellation of cardiovascular co-morbidities seen in patients with OSA, we believe that a strategy of actively screening for the presence of AF in patients with OSA and initiating oral anticoagulation therapy when appropriate may reduce the burden of stroke in this population. This is a question that needs to be addressed in a clinical trial.
Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom; Southampton General Hospital, University Hospitals Southampton NHS Foundation Trust, Tremona Road, SO16 6YD, United Kingdom. Electronic address: Drdgwilson@gmail.com.
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Wilson
Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.
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Frontera
Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.
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Thomas
Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.
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Duncan
D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis*; D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
Atrial fibrillation; Obstructive sleep apnoea; Screening; Stroke