Stroke in Individuals With Hypertrophic Cardiomyopathy and Sleep Apnea.

BACKGROUND

Although both hypertrophic cardiomyopathy (HCM) and sleep apnea syndrome (SAS) independently elevate stroke risk, their combined impact remains poorly characterized. Despite high reported SAS prevalence in HCM cohorts, stroke in this dual-diagnosis population are underexplored.

OBJECTIVES

The objective of the study was to identify factors associated with stroke in patients with comorbid HCM and SAS using the National Inpatient Sample.

METHODS

Using the National Inpatient Sample (2010-2019), 13,581 adults with HCM-SAS were analyzed. Multivariable logistic regression identified stroke-associated factors after adjusting for demographics, comorbidities, and treatment variables.

RESULTS

This nationwide study included HCM-SAS inpatients aged >21 years (mean: 63.48 ± 13.138 years), with a higher proportion of males (53.71%) than females (46.29%). The prevalence of stroke in this cohort was 3.3%. Factors which exhibited an independent association with stroke included female (OR: 1.30), hypertension (OR: 1.48), ischemic heart disease (OR: 1.37), dyslipidemia (OR: 1.55), peripheral vascular disease (OR: 2.17), and urinary tract infections (OR: 1.53). Age 21 to 50 years (OR: 0.722), obesity (OR: 0.69), chronic heart failure (OR: 0.79), and anticoagulant use (OR: 0.76) demonstrated negative association.

CONCLUSIONS

Subjects with HCM and SAS are at risk for stroke. Although known modifiable risk factors should be treated, further studies are needed to better understand the pathobiology and how to mitigate risk in this vulnerable population.