Review Article

The Relationship between Obstructive Sleep Apnea and Atrial Fibrillation: A Complex Interplay

Table 5

OSA and stroke risk.

InvestigatorNumber of patientsPrimary endpointsMean followup (yrs)Control for AFRisk factor adjustmentsResults for stroke

Boden-Albala et al. (2012) [92]2088Ischemic stroke, MI, death5.1YesAge, sex, race, education, WC, systolic and diastolic BP, fasting glucose, HDL, alcohol, smoking, physical activity, PVD, CAD, total cholesterol/HDL level, depression, and medication usage.HR for ischemic stroke in patients with significant dozing was 2.74 (1.38–5.43); HR for all stroke, 3.00 (1.57–5.73)
Redline et al. (2010) [93]5422Ischemic stroke8.7NoAge, race, BMI, smoking, BP, antihypertensives, DM.Adjusted HR for stroke in men with severe OSA was 2.86 (1.10–7.39)
Munoz et al. (2006) [94]394Stroke4.5YesSex.Adjusted HR for stroke in OSA patients was 2.52 (1.04–6.10)
Yaggi et al. (2005) [95]1022Stroke or death3.4YesAge, race, sex, smoking, alcohol consumption, BMI, AF, HTN, and lipids. Unadjusted RR for stroke in OSA was 3.02 (1.27–7.21), death adjusted RR, 1.70 (0.92–3.16)
Arzt et al. (2005) [45]1189Stroke4NoAge, sex, and BMI.Fully adjusted OR for stroke in severe OSA was 3.08 (0.74–12.81)
Marin et al. (2005) [96]1010Fatal MI, stroke10.1NoAge, CV disease, DM, HTN, lipid disorders, smoking, alcohol use, BP, glucose, lipid levels, and CV drugs. OR for fatal MI or stroke in untreated severe OSA was 2.87 (1.17–7.51)
Mooe et al. (2001) [97]408Death, cerebrovascular events, MI5.1NoAge, sex, BMI, HTN, DM, left ventricular function, and coronary intervention. OR for stroke in moderate OSA patients was 2.62 (1.26–5.46), in severe OSA patients, 2.98 (1.43–6.20)
Hu et al. (2000)
[98]
71,779 womenStroke, coronary heart disease, fatal cardiovascular events8NoAge, BMI, cigarette smoking, DM, hypercholesterolemia, menopausal status, family history of MI before age 60, alcohol consumption, multivitamin and vitamin E use, physical activity, number of hours sleeping, and sleep position. Age-adjusted total stroke RR for occasional snorers, 1.60 (1.21–2.12); for regular snorers 1.88 (1.29–2.74).
Multivariate adjusted RR for occasional snorers, 1.42 (1.07–1.89); for regular snorers RR 1.35 (0.91–1.99)

MI: myocardial infarction; WC: waist circumference; BP: blood pressure; HDL: high density lipoprotein; PVD: peripheral vascular disease; CAD: coronary artery disease; BMI: body mass index; HR: hazard ratio; DM: diabetes mellitus; HTN: hypertension; RR: relative risk; OR: odds ratio; CV: cardiovascular.