Effect of CPAP Treatment of Sleep Apnea on Clinical Prognosis After Ischemic Stroke: An Observational Study
Study Objectives:To evaluate continuous positive airway pressure (CPAP) treatment in patients with moderate to severe sleep-disordered breathing (SDB) after an ischemic stroke.Methods: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]
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
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ConclusionsCARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC.
CONCLUSIONS: CSR frequently occurs in strokes involving large arteries or due to cardioembolism, regardless of the location and severity of the stroke. Predisposing conditions such as preexisting neurologic disability, low LVEF, and LA enlargement are associated with CSR in acute stroke. PMID: 30198229 [PubMed - as supplied by publisher]
Atrial fibrillation (AF) is a risk factor for ischemic stroke and reported to be associated with severe obstructive sleep apnea (OSA). The aim of this study was to determine the occurrence of newly detected AF in patients with severe OSA and no prior history of AF. Prospective observational study included patients with severe OSA (Apnea-Hypopnea Index (AHI) ≥ 30) and no history of AF. Primary outcome was detection of AF lasting ≥10 s. Patients were subjected to 2 24-hour Holter monitors, and if no AF was detected, implanted with a Medtronic Reveal XT implantable loop recorder (ILR).
AbstractPurpose of ReviewIn this article, we review the cerebrovascular complications of sleep apnea (SA). SA is the major sleep disorder associated with stroke and vascular dementia.Recent FindingsSleep apnea syndrome of moderate to severe intensity affects 17% of 50 –70-year-old men and 9% of 50–70-year-old women, making SA a notorious and prevalent disorder. SA increases the risk of hypertension, stroke, myocardial infarction, and atrial fibrillation (AF) and is closely linked to vascular dementia. In addition, SA may worsen the neurologic outcome in acute stroke patients and interferes with rehabilitation a...
Conclusions: A significant number of stroke and TIA patients who underwent PSG have PLMs and moderate-severe OSA. Stroke and TIA patients with atrial fibrillation are more likely to have moderate-severe OSA and may benefit from PSG evaluation.
Conclusions -SCAF is frequently detected by continuous electrocardiographic monitoring in older patients without prior history of AF who are attending outpatient cardiology and neurology clinics. Its clinical significance is unclear. Clinical Trial Registration -URL: www.ClinicalTrials.gov Unique Identifier: NCT01694394. PMID: 28778946 [PubMed - as supplied by publisher]
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.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.