Abstract
Study Objectives: Coronary artery disease is considered to be the major cause of death amongst patients with ischemic stroke. The coronary artery calcium (CAC) score is related not only to sleep-disordered breathing, but also with future risk of cardiovascular mortality. We investigated the association between the severity of sleep-disordered breathing and CAC score in patients with ischemic stroke.Methods: We included 32 patients who underwent coronary multichannel computed tomography and polysomnography (within 2 years of the stroke event) amongst the patients admitted to our clinic due to acute ischemic stroke. We investigated vascular risk factors, polysomnography findings, and sleep questionnaire scores, and their relationships with the CAC score.Results: All patients were found to have sleep apnea of any degree, and 23 (72%) had severe sleep apnea. Twenty-three (72%) patients had a positive CAC score. Higher CAC scores were associated with elevated respiratory disturbance index (RDI), apnea index, oxygen desaturation index, and STOP-BANG test scores. Multivariate analysis after adjusting for potential confounding factors revealed independent relationships between the CAC score and the RDI (ß [SE] = 5.3 [2.1], p = 0.01), oxygen desaturation index (ß [SE] = 6.8 [2.8], p = 0.02), and STOP-BANG test score (ß [SE] = 90.3 [37.7], p = 0.02).Conclusion: Our findings indicate a relationship between coronary atherosclerotic burden measured by the CAC score and the severity of sleep apnea. Performing polysomnography could be useful for investigating the severity of hidden coronary artery disease among these patients.Brief SummaryCurrent Knowledge/Study Rationale: The effect of sleep apnea on coronary artery disease in patients with ischemic stroke has not been explored. We investigated the relationship between sleep apnea, its related characteristics and the coronary artery calcium score in patients with stroke.Study Impact: Our findings reveal a close relationship between the atherosclerosis-related burden measured by the coronary artery calcium score and the severity of sleep apnea that persisted after adjusting for confounding variables related to the risk of coronary artery disease. Proper detection and treatment of sleep apnea might mitigate the risk of future coronary events in patients with ischemic stroke.
Highlights
Sleep apnea is a condition characterized by recurrent episodes of airflow limitation during sleep resulting in frequent awakening, hypoxia, and sympathetic activation [1]
We investigated the association between the severity of sleep apnea, and the CAC score in patients with ischemic stroke with no previous history of CAD
Univariate analysis of coronary artery calcium scores and clinical and sleep questionnaire variables is shown in Supplementary Table 1
Summary
Sleep apnea is a condition characterized by recurrent episodes of airflow limitation during sleep resulting in frequent awakening, hypoxia, and sympathetic activation [1]. Individuals with sleep apnea have been reported to show an increased risk of cardiovascular diseases [2, 3]. Given the association between the risk of CAOD and prevalence of sleep apnea in an otherwise healthy population [9], the atherosclerotic burden on the coronary artery may be dependent on the severity of sleep apnea in patients with stroke in whom sleep apnea is common. This association has not been duly explored until now
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
