HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Martínez-García, M. A. Articles by Salcedo-Maiques, E. Search for Related Content PubMed PubMed Citation Articles by Martínez-García, M. A. Articles by Salcedo-Maiques, E.

Continuous Positive Airway Pressure Treatment in Sleep Apnea Prevents New Vascular Events After Ischemic Stroke^*

^* From the Pneumology (Drs. Martínez-García and Soler-Cataluña) and Neurology Units (Dr. Galiano-Blancart), and Service of Internal Medicine (Drs. Román-Sánchez, Cabero-Salt, and Salcedo-Maiques), Requena General Hospital, Valencia, Spain.

Correspondence to: Miguel Ángel Martínez-García, MD, Hospital General de Requena, Unidad de Neumología (Servicio de Medicina Interna), Paraje Casa Blanca s/n, 46320-Requena, Valencia, Spain; e-mail: med013413{at}nacom.es

Study objectives: A study was made of the role of continuous positive airway pressure (CPAP) treatment in the prevention of new vascular events following ischemic stroke or transient ischemic attack.

Design: Prospective study.

Patients and interventions: Demographic data, vascular risk factors, clinical manifestations associated to sleep apnea-hypopnea syndrome, and neurologic parameters were recorded in a group of patients presenting with acute ischemic stroke at least 2 months previously. A polygraphic study was carried out 2 months after the acute episode in all patients, with the prescription of CPAP in the event of an apnea-hypopnea index (AHI) 20. Two groups were defined: patients who could tolerate CPAP (group 1), and patients who could not tolerate CPAP after 1 month of initial adaptation (group 2). Patients with an AHI < 20 were excluded. The incidence of new vascular events was evaluated throughout follow-up (18 months) in all patients, with an analysis of the role of CPAP in protecting the patients against such events.

Results: Ninety-five patients were studied. Fifty-one patients (53.7%; mean age, 72.7 ± 9.4 years [± SD]) presented with an AHI 20, and 15 patients (29.4%) tolerated CPAP. The incidence of new vascular events was greater in group 2 (6.7%) vs group 1 (36.1%; long-rank, p = 0.03). Intolerance of CPAP increased the probability of a new vascular event fivefold (odds ratio, 5.09) adjusted for other vascular risk factors and neurologic indexes.

Conclusions: We concluded that CPAP treatment during 18 months in patients with an AHI 20 afforded significant protection against new vascular events after ischemic stroke.

Key Words: continuous positive airway pressure • ischemic stroke • sleep apnea • vascular events

This article has been cited by other articles:

				A. V. Alexandrov, V. K. Sharma, A. Y. Lao, G. Tsivgoulis, M. D. Malkoff, and A. W. Alexandrov Reversed Robin Hood Syndrome in Acute Ischemic Stroke Patients Stroke, November 1, 2007; 38(11): 3045 - 3048. [Abstract] [Full Text] [PDF]