Effect of CPAP Treatment of Sleep Apnea on Clinical Prognosis After Ischemic Stroke: An Observational Study.

Détails

ID Serval
serval:BIB_EE878311CEBC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Effect of CPAP Treatment of Sleep Apnea on Clinical Prognosis After Ischemic Stroke: An Observational Study.
Périodique
Journal of clinical sleep medicine
Auteur(s)
Haba-Rubio J., Vujica J., Franc Y., Michel P., Heinzer R.
ISSN
1550-9397 (Electronic)
ISSN-L
1550-9389
Statut éditorial
Publié
Date de publication
15/06/2019
Peer-reviewed
Oui
Volume
15
Numéro
6
Pages
839-847
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
To evaluate continuous positive airway pressure (CPAP) treatment in patients with moderate to severe sleep-disordered breathing (SDB) after an ischemic stroke.
We identified patients included in the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) who underwent polysomnography after an ischemic stroke. We compared patients without significant SDB (apnea-hypopnea index [AHI] < 15 events/h: SDB-), with AHI ≥ 15 events/h who refused CPAP or with poor CPAP adherence (SDB+ CPAP-), and patients with SDB effectively treated by CPAP (SDB+ CPAP+).
We analyzed data from 101 patients (age 68.5 ± 11.1 years, 84.1% men). In multivariate analysis the SDB+ CPAP+ group was associated with a significant reduction of stroke recurrence and mortality (odds ratio 0.13, 95% confidence interval 0.00-0.86, P = .031), whereas atrial fibrillation was independently associated with a higher risk (odds ratio 4.32, 95% confidence interval 1.51-12.33, P = .006). Event-free survival analysis (stroke recurrence and death) after 2-year follow-up showed that those in the SDB+ CPAP+ group had significantly higher cardiovascular survival, and Cox proportion hazard model identified CPAP treatment as significantly associated with survival time (P = .025). The AHI and the National Institutes of Health Stroke Scale subacute score were independently associated with CPAP adherence among patients with SDB.
This observational study shows that CPAP treatment in stroke patients with moderate to severe SDB is associated with lower rates of stroke recurrence and death.
Mots-clé
cerebrovascular recurrence, mortality, nasal continuous positive airway pressure, neurologic outcome, polysomnography
Pubmed
Web of science
Création de la notice
01/08/2019 10:12
Dernière modification de la notice
20/08/2019 17:16
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