Abstract 2457: Atrial Fibrillation is Associated with Severe Sleep Disordered Breathing TIA and Stroke Patients

Abstract

Background and Purpose Sleep disordered breathing (SBD) was reported to be a risk factor for cerebrovascular disease. We investigated the frequency of SDB in Japanese patients with acute transient ischemic attack (TIA) and stroke and the factors associated with severe SDB in Japan. Methods Between May 2010 and April 2011, we prospectively enrolled TIA and stroke patients within 24 hours of onset and performed sleep study up to 7 days after admission. SBD was defined as respiratory disturbance index (RDI: apnea or hypopnea event per hour) ≥5. Patients were divided into 2 groups according to the RDI value as follows: ≥30(severe) and <30(none or non-severe). We demonstrated the frequency of SDB and the factors associated with severe SDB were investigated by multivariate regression analysis. Results A total of 150 patients (92 males; mean age, 72.8 years) were enrolled in this study; 28 had TIA and 122 had stroke. The mean time from admission to sleep study was 4 days. Mean RDI was 22.2±17.6. SDB was observed in 126(84%) patients. Frequencies of SDB were as follows: 21(75%) patients in TIA, 105(86%) in stroke [8/10(80%) in large artery atherosclerosis, 14/14(100%) in small vessel occlusion, 37/41(90%) in cardioembolism, 46/57(81%) in other cause of stroke/undetermined]. Severe SDB was observed in 44 (29%) patients; 21% in TIA and 31% in stroke. Frequencies of male (75% for the severe SDB group vs. 56% for the non-severe SDB group, p=0.027), atrial fibrillation (39% vs. 23%, p=0.045), body mass index (23.8±3.8 vs. 22.3±3.8, p=0.043), and neck circumference (37.8±4.3 vs. 35.8±4.2, p=0.012) were significantly higher in the severe SDB than in the non-severe SDB. Metabolic syndrome (36% vs. 21%, p=0.057) and waist circumference (88.9±9.8 vs. 85.5±9.3, p=0.080) showed a tendency toward higher in the severe SDB group than in the non-severe SDB group. There were no significant differences in age, prior stroke, vascular risk factors, Glasgow Coma Scale, and NIHSS score on admission. On multivariate regression analysis, atrial fibrillation (odds ratio, 2.5; 95% confidence interval, 1.079-5.836, p=0.0326) was found to be independently associated with severe SDB. Conclusions Most Japanese patients with acute TIA and stroke had SDB, and the presence of atrial fibrillation was associated with severe SDB.