Cerebrovascular diseases (Basel, Switzerland) · 2007
Atherosclerosis and obstructive sleep apnea in patients with ischemic stroke.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Dziewas Rainer, Ritter Martin, Usta Nesrin, Boentert Matthias, Hor Hyon, Dittrich Ralf, Schäbitz Wolf R, Ringelstein E Bernd, Young Peter
Аннотация
BACKGROUND: Of late, obstructive sleep apnea (OSA) has been suggested to be a risk factor for atherosclerotic artery disease. In the present study, we analyzed the prevalence of atherosclerosis in stroke patients with and without OSA.
PATIENTS AND METHODS: Two hundred and fourteen consecutive patients with ischemic stroke were included in this study. Patients were screened for classical cerebrovascular risk factors. All patients received a cardiorespiratory polygraphy to determine the apnea-hypopnea index. Duplex ultrasonography was used to evaluate the carotid bulb and the internal carotid artery for the presence of atherosclerotic lesions, which were graded in 'none', 'plaques with <50% stenosis', 'stenosis > or =50% to subtotal', and 'occlusion'.
RESULTS: Atherosclerotic lesions were identified in 42% of patients. These were significantly more prevalent in patients with OSA than in patients without. In multiple logistic regression analysis, this association was independent of other known vascular risk factors. Arterial hypertension, which was significantly related to atherosclerosis in univariate analysis, lost its statistical impact in multivariate analysis.
CONCLUSION: This study confirms that OSA is an independent risk factor for atherosclerotic artery disease that may even outweigh the impact of arterial hypertension in selected patient collectives. To further elucidate this topic, treatment studies are needed that look for a possible improvement of markers and signs of atherosclerosis in patients with OSA.
PATIENTS AND METHODS: Two hundred and fourteen consecutive patients with ischemic stroke were included in this study. Patients were screened for classical cerebrovascular risk factors. All patients received a cardiorespiratory polygraphy to determine the apnea-hypopnea index. Duplex ultrasonography was used to evaluate the carotid bulb and the internal carotid artery for the presence of atherosclerotic lesions, which were graded in 'none', 'plaques with <50% stenosis', 'stenosis > or =50% to subtotal', and 'occlusion'.
RESULTS: Atherosclerotic lesions were identified in 42% of patients. These were significantly more prevalent in patients with OSA than in patients without. In multiple logistic regression analysis, this association was independent of other known vascular risk factors. Arterial hypertension, which was significantly related to atherosclerosis in univariate analysis, lost its statistical impact in multivariate analysis.
CONCLUSION: This study confirms that OSA is an independent risk factor for atherosclerotic artery disease that may even outweigh the impact of arterial hypertension in selected patient collectives. To further elucidate this topic, treatment studies are needed that look for a possible improvement of markers and signs of atherosclerosis in patients with OSA.