Severity of OSA Is an Independent Predictor of Incident Atrial Fibrillation Hospitalization in a Large Sleep-Clinic Cohort

Cadby, Gemma; McArdle, Nigel; Briffa, Tom; Hillman, David R.; Simpson, Laila; Knuiman, Matthew; Hung, Joseph

doi:10.1378/chest.15-0229

Cited by 173 publications

(106 citation statements)

References 27 publications

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“…28 In addition, the left ventricular diastolic dysfunction induced by apnea-related hypoxia 29 may increase left atrial pressure and size, which is a well-known AF risk factor. Our results also agree with two large-scale longitudinal studies 1,5 that suggested that nocturnal desaturation instead of AHI is a putative mechanism of the link between OSA and the development of AF in stroke-free subjects younger than 65 years. As DI is a rate calculated as the number of desaturation events per hour of sleep, it cannot Values are presented as Spearman rho (P value) unless otherwise indicated.…”

Section: Discussionsupporting

confidence: 92%

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Nocturnal Desaturation is Associated With Atrial Fibrillation in Patients With Ischemic Stroke and Obstructive Sleep Apnea

Chen

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Both atrial fibrillation (AF) and obstructive sleep apnea (OSA) are risk factors for ischemic stroke. Previous studies suggested that OSA is associated with AF in individuals who have not had a stroke. For better secondary prevention of stroke, this study determined the association between OSA and AF among patients with ischemic stroke. Methods: This cross-sectional study recruited consecutive patients with subacute ischemic stroke admitted for neurorehabilitation. The baseline and clinical data were collected, and standard polysomnography was performed in a sleep center. Results:The 47 women and 111 men enrolled in this study were divided into two groups according to the presence of AF. The AF group (n = 26) had a significantly older age (72.2 versus 60.1 years, P = .016), significantly more disability (Barthel index: 35 versus 45, P = .045), and marginally higher mean oxygen desaturation (6.7% versus 5.6%, P = .079) compared to the non-AF group. The two groups did not significantly differ in sex, body mass index, prevalence of hyperthyroidism, and other parameters of OSA. The multivariate logistic regression analysis revealed that mean desaturation was significantly associated with AF after adjusting for age, neck circumference, Barthel index and high-density lipoprotein level (odds ratio = 1.19 (95% confidence interval 1.05-1.35), P = .008). Conclusions: Nocturnal hypoxia due to OSA is an independent predictor of AF in patients with subacute ischemic stroke. The use of overnight pulse oximeter to assess nocturnal hypoxia and predict paroxysmal AF in patients with cryptogenic stroke needs further evaluation. Commentary: A commentary on this article appears in this issue on page 667. Keywords: atrial fibrillation, hypoxia, ischemic stroke, obstructive sleep apnea Citation: Chen CY, Ho CH, Chen CL, Yu CC. Nocturnal desaturation is associated with atrial fibrillation in patients with ischemic stroke and obstructive sleep apnea. J Clin Sleep Med. 2017;13(5):729-735.

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Section: Discussionsupporting

confidence: 92%

“…[1][2][3][4][5] The estimated prevalence of OSA in patients with AF is 32% to 49%. 6 OSA is also a known independent risk factor for incident AF in individuals younger than 65 years.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal Desaturation is Associated With Atrial Fibrillation in Patients With Ischemic Stroke and Obstructive Sleep Apnea

Chen

et al. 2017

Journal of Clinical Sleep Medicine

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“…Severe OSA can raise blood pressure, 4 provoke atrial fibrillation, 5 and probably increase the risk of strokes and heart attacks. 6 However, there are much better and more established therapies for reducing such vascular risks.…”

Section: Treatmentmentioning

confidence: 99%

Obstructive sleep apnoea: is it moving into primary care?

Stradling

2016

Br J Gen Pract

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“…A recent study evaluated 6,841 individuals for OSA at a sleep clinic over a period of 11.9 years 40 . Age, BMI, HTN, T2DM, VHD, CHD or peripheral artery disease, HF, and chronic obstructive pulmonary disease were all univariate predictors of AF (all P<0.001).…”

Section: Obstructive Sleep Apnea (Osa)mentioning

confidence: 99%

Lifestyle Modification in the Prevention and Treatment of Atrial Fibrillation

Menezes¹,

Lavie²,

Schutter³

et al. 2015

Progress in Cardiovascular Diseases

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A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTAtrial fibrillation (AF) is the most common arrhythmia worldwide and has a significant impact on morbidity and mortality. Additionally, the incidence and prevalence of AF is expected to increase in the United States and worldwide over the next few decades. While the pathophysiology concerning the development of AF is not completely understood, multiple modifiable, as well as non-modifiable risk factors, for AF development have been discovered.

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Severity of OSA Is an Independent Predictor of Incident Atrial Fibrillation Hospitalization in a Large Sleep-Clinic Cohort

Cited by 173 publications

References 27 publications

Nocturnal Desaturation is Associated With Atrial Fibrillation in Patients With Ischemic Stroke and Obstructive Sleep Apnea

Nocturnal Desaturation is Associated With Atrial Fibrillation in Patients With Ischemic Stroke and Obstructive Sleep Apnea

Obstructive sleep apnoea: is it moving into primary care?

Lifestyle Modification in the Prevention and Treatment of Atrial Fibrillation

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