Sleep-disordered breathing a red flag for ischaemic stroke recurrence
Sleep-disordered breathing (SDB) is associated with an increased risk of recurrent ischaemic stroke but not mortality, a study has shown.
The study included 842 ischaemic stroke patients (median age, 65 years; 47 percent female) from the BASIC* project. All patients underwent screening for SDB (defined as respiratory event index [REI] score ≥10) with the ApneaLink Plus device, as well as active and passive surveillance for recurrent ischaemic stroke.
Results showed that the median REI score was 14 (interquartile range, 6–26), with more than half of the population (63 percent) having SDB. SDB was associated with male sex, Mexican American ethnicity, lower educational attainment, higher body mass index, nonsmoking status, diabetes mellitus and hypertension.
Among 775 Mexican American and non-Hispanic whites with an index stroke event and complete data, 85 (11 percent) recurrent ischaemic stroke events and 104 (13 percent) deaths occurred over a median follow-up of 591 days.
In fully adjusted cause-specific proportional hazards models, REI was associated with an increased risk of recurrent ischaemic stroke (1-unit higher REI score: hazard ratio [HR], 1.02; 95 percent CI, 1.01–1.03) but not with the risk of mortality alone (HR, 1.00; 0.99–1.02).
According to researchers, SDB could not explain the previously identified higher risk of recurrent stroke in Mexican Americans vs non-Hispanic whites. Nevertheless, the present data support the need for a trial of SDB treatment for recurrent stroke prevention regardless of ethnicity.
*Brain Attack Surveillance in Corpus Christ