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Impact of Sleep Apnea on Cardioembolic Risk in Patients With Atrial Fibrillation: Data From the ESADA Cohort

Lombardi Carolina; Faini Andrea; Pataka Athanasia; Joppa Pavol; Hein Holger; Pengo Martino F; Ludka Ondrej; Dogas Zoran; Mihaicuta Stefan; Ryan Silke; Parati Gianfranco; and on behalf of the ESADA Working Group; Grote Ludger; Anttalainen Ulla

Impact of Sleep Apnea on Cardioembolic Risk in Patients With Atrial Fibrillation: Data From the ESADA Cohort

Lombardi Carolina
Faini Andrea
Pataka Athanasia
Joppa Pavol
Hein Holger
Pengo Martino F
Ludka Ondrej
Dogas Zoran
Mihaicuta Stefan
Ryan Silke
Parati Gianfranco; and on behalf of the ESADA Working Group
Grote Ludger
Anttalainen Ulla
Katso/Avaa
Final draft (1.526Mb)
Lataukset: 

American Heart Association
doi:10.1161/STROKEAHA.120.030285
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042822230
Tiivistelmä

Background and purpose: An accurate determination of the cardioembolic risk in patients with atrial fibrillation (AF) is crucial to prevent consequences like stroke. Obstructive sleep apnea (OSA) is a known risk factor for both AF and stroke. We aim to explore a possible association between OSA and an increased cardioembolic risk in patients with AF.

Methods: We assessed data from the ESADA (European Sleep Apnea Database) cohort where patients with known AF and OSA were included. Parameters of OSA severity and related hypoxia like lowest Spo2 and 4% oxygen desaturation index were analyzed. Patients were stratified according to their cardioembolic risk estimated with the CHA2DS2-VASc score.

Results: From the initial cohort of 14 646 patients, a final set of 363 patients were included in the analysis. Indices of hypoxia during sleep were associated with increased CHA2DS2-VASc score (4% oxygen desaturation index 17.9 versus 29.6 versus 30.5 events/hour and the lowest Spo2 81.2 versus 77.8 versus 77.5% for low, moderate, and high cardioembolic risk, respectively, P<0.05).

Conclusions: These results support the potential role of OSA-related hypoxia in the risk for cardioembolic complications such as stroke in patients with AF.

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