nach oben

Sleep and Breathing

Erschienen in:

19.06.2020 | Sleep Breathing Physiology and Disorders • Original Article

Association between the high risk for obstructive sleep apnea and intracranial carotid artery calcification in patients with acute ischemic stroke

verfasst von: Ho Geol Woo, Tae-Jin Song, Jo Sung Jung, Se Won Oh, Seung Cheol Lee, Jin Myoung Seok, Kwang Ik Yang

Erschienen in: Sleep and Breathing | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Obstructive sleep apnea (OSA) is an independent risk factor for stroke. Furthermore, intracranial carotid artery calcification (ICAC) is a marker for subclinical atherosclerosis and future cardiovascular events. We investigated the association between the high risk for OSA and ICAC in patients with acute ischemic stroke.

Methods

We retrospectively investigated 73 patients who were admitted to the hospital with acute ischemic stroke in the internal carotid artery (ICA) territory due to large-artery atherosclerosis. The risk for OSA was assessed using the Berlin Questionnaire, and patients were classified into low-risk (LR-OSA) and high-risk groups (HR-OSA). We compared the burden of ICAC between the two groups. Univariable and multivariable analyses were conducted to investigate the association of high risk for OSA with the presence of calcium in intracranial ICA.

Results

The HR-OSA group of 35 patients (48%) was significantly older and had a higher rate of hypertension and diabetes mellitus than the LR-OSA group. The HR-OSA group had more frequent ICAC (92% vs. 63%, p < 0.001), higher Agatston score (162.0 vs. 8.5, p < 0.001), and greater total volume of ICAC (261.2 mm³ vs. 20.1 mm³, p < 0.001) in the intracranial ICA. Presence of calcium in symptomatic intracranial ICA was positively correlated with age (odds ratio, OR, 1.432; 95% confidence interval, CI, 1.098–1.868) and HR-OSA (OR, 18.272; 95% CI, 0.500–668.401) in multivariable logistic regression analysis.

Conclusions

This study showed that the presence of calcium in symptomatic intracranial ICA was related to high risk for OSA in patients with acute ischemic stroke.

Nur mit Berechtigung zugänglich

Bradley TD, Floras JS (2009) Obstructive sleep apnoea and its cardiovascular consequences. Lancet 373(9657):82–93. https://doi.org/10.1016/S0140-6736(08)61622-0CrossRefPubMed

Song TJ, Park JH, Choi KH, Chang Y, Moon J, Kim JH, Choi Y, Kim YJ, Lee HW (2017) Moderate-to-severe obstructive sleep apnea is associated with cerebral small vessel disease. Sleep Med 30:36–42. https://doi.org/10.1016/j.sleep.2016.03.006CrossRefPubMed

Song TJ, Park JH, Choi KH, Kim JH, Choi Y, Chang Y, Kim HJ, Moon J, Kim YJ, Lee HW (2017) Is obstructive sleep apnea associated with the presence of intracranial cerebral atherosclerosis? Sleep Breath 21(3):639–646. https://doi.org/10.1007/s11325-016-1450-9CrossRefPubMed

Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353(19):2034–2041. https://doi.org/10.1056/NEJMoa043104CrossRefPubMed

Lipford MC, Flemming KD, Calvin AD, Mandrekar J, Brown RD Jr, Somers VK, Caples SM (2015) Associations between cardioembolic stroke and obstructive sleep apnea. Sleep 38(11):1699–1705. https://doi.org/10.5665/sleep.5146CrossRefPubMedPubMedCentral

Disler P, Hansford A, Skelton J, Wright P, Kerr J, O'Reilly J, Hepworth J, Middleton S, Sullivan C (2002) Diagnosis and treatment of obstructive sleep apnea in a stroke rehabilitation unit: a feasibility study. Am J Phys Med Rehabil 81(8):622–625CrossRefPubMed

Johnson KG, Johnson DC (2010) Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med 6(2):131–137CrossRefPubMedPubMedCentral

Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70–81. https://doi.org/10.1016/j.smrv.2016.07.002CrossRefPubMed

Kim J, In K, Kim J, You S, Kang K, Shim J, Lee S, Lee J, Lee S, Park C, Shin C (2004) Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 170(10):1108–1113. https://doi.org/10.1164/rccm.200404-519OCCrossRefPubMed

10.

Sunwoo JS, Hwangbo Y, Kim WJ, Chu MK, Yun CH, Yang KI (2018) Prevalence, sleep characteristics, and comorbidities in a population at high risk for obstructive sleep apnea: a nationwide questionnaire study in South Korea. PLoS One 13(2):e0193549. https://doi.org/10.1371/journal.pone.0193549CrossRefPubMedPubMedCentral

11.

Kwon Y, Duprez DA, Jacobs DR, Nagayoshi M, McClelland RL, Shahar E, Budoff M, Redline S, Shea S, Carr JJ, Lutsey PL (2014) Obstructive sleep apnea and progression of coronary artery calcium: the multi-ethnic study of atherosclerosis study. J Am Heart Assoc 3(5):e001241. https://doi.org/10.1161/JAHA.114.001241CrossRefPubMedPubMedCentral

12.

Peters SA, den Ruijter HM, Bots ML, Moons KG (2012) Improvements in risk stratification for the occurrence of cardiovascular disease by imaging subclinical atherosclerosis: a systematic review. Heart 98(3):177–184. https://doi.org/10.1136/heartjnl-2011-300747CrossRefPubMed

13.

Mauriello A, Servadei F, Zoccai GB, Giacobbi E, Anemona L, Bonanno E, Casella S (2013) Coronary calcification identifies the vulnerable patient rather than the vulnerable plaque. Atherosclerosis 229(1):124–129. https://doi.org/10.1016/j.atherosclerosis.2013.03.010CrossRefPubMed

14.

Cho KH, Lee DH, Kim KM, Choi YH, Nam HS, Heo JH, Heo K, Kim YD (2019) Relationship between sleep apnea and coronary artery calcium in patients with ischemic stroke. Front Neurol 10:819. https://doi.org/10.3389/fneur.2019.00819CrossRefPubMedPubMedCentral

15.

Alexopoulos N, Raggi P (2009) Calcification in atherosclerosis. Nat Rev Cardiol 6(11):681–688. https://doi.org/10.1038/nrcardio.2009.165CrossRefPubMed

16.

Bugnicourt JM, Leclercq C, Chillon JM, Diouf M, Deramond H, Canaple S, Lamy C, Massy ZA, Godefroy O (2011) Presence of intracranial artery calcification is associated with mortality and vascular events in patients with ischemic stroke after hospital discharge: a cohort study. Stroke 42(12):3447–3453. https://doi.org/10.1161/STROKEAHA.111.618652CrossRefPubMed

17.

Bos D, Portegies ML, van der Lugt A, Bos MJ, Koudstaal PJ, Hofman A, Krestin GP, Franco OH, Vernooij MW, Ikram MA (2014) Intracranial carotid artery atherosclerosis and the risk of stroke in whites: the Rotterdam study. JAMA Neurol 71(4):405–411. https://doi.org/10.1001/jamaneurol.2013.6223CrossRefPubMed

18.

Kim JM, Park KY, Bae JH, Han SH, Jeong HB, Jeong D (2019) Intracranial arterial calcifications can reflect cerebral atherosclerosis burden. J Clin Neurol 15(1):38–45. https://doi.org/10.3988/jcn.2019.15.1.38CrossRefPubMed

19.

Kang K, Park KS, Kim JE, Kim SW, Kim YT, Kim JS, Lee HW (2013) Usefulness of the Berlin questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study. Sleep Breath 17(2):803–810. https://doi.org/10.1007/s11325-012-0767-2CrossRefPubMed

20.

Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832CrossRefPubMed

21.

Tachikawa R, Koyasu S, Matsumoto T, Hamada S, Azuma M, Murase K, Tanizawa K, Inouchi M, Oga T, Mishima M, Togashi K, Chin K (2015) Obstructive sleep apnea and abdominal aortic calcification: is there an association independent of comorbid risk factors? Atherosclerosis 241(1):6–11. https://doi.org/10.1016/j.atherosclerosis.2015.04.801CrossRefPubMed

22.

Lutsey PL, McClelland RL, Duprez D, Shea S, Shahar E, Nagayoshi M, Budoff M, Kaufman JD, Redline S (2015) Objectively measured sleep characteristics and prevalence of coronary artery calcification: the multi-ethnic study of atherosclerosis sleep study. Thorax 70(9):880–887. https://doi.org/10.1136/thoraxjnl-2015-206871CrossRefPubMed

23.

van Dijk AC, Fonville S, Zadi T, van Hattem AM, Saiedie G, Koudstaal PJ, van der Lugt A (2014) Association between arterial calcifications and nonlacunar and lacunar ischemic strokes. Stroke 45(3):728–733. https://doi.org/10.1161/STROKEAHA.113.003197CrossRefPubMed

24.

Berliner JA, Navab M, Fogelman AM, Frank JS, Demer LL, Edwards PA, Watson AD, Lusis AJ (1995) Atherosclerosis: basic mechanisms. Oxidation, inflammation, and genetics. Circulation 91(9):2488–2496CrossRefPubMed

25.

Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG (2017) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of sleep medicine clinical practice guideline. J Clin Sleep Med 13(3):479–504. https://doi.org/10.5664/jcsm.6506CrossRefPubMedPubMedCentral

26.

Kepplinger J, Barlinn K, Albright KC, Schrempf W, Boehme AK, Pallesen LP, Schwanebeck U, Graehlert X, Storch A, Reichmann H, Alexandrov AV, Bodechtel U (2013) Early sleep apnea screening on a stroke unit is feasible in patients with acute cerebral ischemia. J Neurol 260(5):1343–1350. https://doi.org/10.1007/s00415-012-6803-0CrossRefPubMed

27.

ElKholy SH, Amer HA, Nada MM, Nada MA, Labib A (2012) Sleep-related breathing disorders in cerebrovascular stroke and transient ischemic attacks: a comparative study. J Clin Neurophysiol 29(2):194–198. https://doi.org/10.1097/WNP.0b013e31824d96b0CrossRefPubMed

28.

Wu XH, Chen XY, Wang LJ, Wong KS (2016) Intracranial artery calcification and its clinical significance. J Clin Neurol 12(3):253–261. https://doi.org/10.3988/jcn.2016.12.3.253CrossRefPubMedPubMedCentral

29.

Drager LF, Polotsky VY, Lorenzi-Filho G (2011) Obstructive sleep apnea: an emerging risk factor for atherosclerosis. Chest 140(2):534–542. https://doi.org/10.1378/chest.10-2223CrossRefPubMedPubMedCentral

30.

Lee SA, Amis TC, Byth K, Larcos G, Kairaitis K, Robinson TD, Wheatley JR (2008) Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 31(9):1207–1213PubMedPubMedCentral

31.

Amatoury J, Howitt L, Wheatley JR, Avolio AP, Amis TC (2006) Snoring-related energy transmission to the carotid artery in rabbits. J Appl Physiol (1985) 100(5):1547–1553. https://doi.org/10.1152/japplphysiol.01439.2005CrossRef

32.

Savransky V, Jun J, Li J, Nanayakkara A, Fonti S, Moser AB, Steele KE, Schweitzer MA, Patil SP, Bhanot S, Schwartz AR, Polotsky VY (2008) Dyslipidemia and atherosclerosis induced by chronic intermittent hypoxia are attenuated by deficiency of stearoyl coenzyme A desaturase. Circ Res 103(10):1173–1180. https://doi.org/10.1161/CIRCRESAHA.108.178533CrossRefPubMedPubMedCentral

33.

A AT (2015) Obstructive sleep apnoea and vascular disease in patients with type 2 diabetes. Eur Endocrinol 11(2):81–89. https://doi.org/10.17925/EE.2015.11.02.81CrossRef

34.

Arzt M, Young T, Finn L, Skatrud JB, Bradley TD (2005) Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med 172(11):1447–1451. https://doi.org/10.1164/rccm.200505-702OCCrossRefPubMedPubMedCentral

Titel: Association between the high risk for obstructive sleep apnea and intracranial carotid artery calcification in patients with acute ischemic stroke
verfasst von: Ho Geol Woo
Tae-Jin Song
Jo Sung Jung
Se Won Oh
Seung Cheol Lee
Jin Myoung Seok
Kwang Ik Yang
Publikationsdatum: 19.06.2020
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 1/2021
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02117-x

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Association between the high risk for obstructive sleep apnea and intracranial carotid artery calcification in patients with acute ischemic stroke

Abstract

Purpose

Methods

Results

Conclusions

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2021

Smoking and sleep apnea duration mediated the sex difference in daytime sleepiness in OSA patients

NOX4, MDA, IMA and oxidative DNA damage: can these parameters be used to estimate the presence and severity of OSA?

Mandibular biomechanical behavior of rats submitted to chronic intermittent or continuous hypoxia and periodontitis

Serum periostin and TNF-α levels in patients with obstructive sleep apnea-hypopnea syndrome

The effect of in-lab polysomnography and home sleep polygraphy on sleep position

The effect of nocturnal “meat” versus “vegetarian” dinners on sleep quality and daily functioning

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin