Enhanced Risk Stratification of Atrial Fibrillation Detected After Ischemic Stroke and TIA: The Role of Apnoea-Hypopnoea Index and Hypoxic Burden-A Study From the Bern Sleep-Stroke Registry.
Publisher DOI
PubMed ID
42035989
Abstract
Sleep-disordered breathing is an independent risk factor for stroke and atrial fibrillation. Accurate assessment of atrial fibrillation in stroke patients with sleep-disordered breathing is crucial for secondary prevention. This study aimed to determine whether combining apnoea-hypopnoea index and hypoxic burden improves risk stratification for atrial fibrillation detected after ischemic stroke. About 911 patients with ischemic stroke underwent respiratory polygraphy within 3 days after an event. Hypoxic burden was defined as the cumulative area under the oxygen desaturation curve of respiratory events. Atrial fibrillation was monitored with up to three 7-day electrocardiogram recordings within 6 months. Patients were stratified by apnoea-hypopnoea index (≥ 15 vs. < 15 events/h) and by hypoxic burden (above vs. below the median, 35% min h-1). Logistic regression adjusted for age, sex, and cardiovascular risk factors assessed associations between apnoea-hypopnoea index/hypoxic burden categories and atrial fibrillation. Among 911 patients (mean age 66 ± 14 years, 62% male), atrial fibrillation was detected in 145 (16%) patients. Patients with both apnoea-hypopnoea index ≥ 15 and high hypoxic burden had nearly double the odds of atrial fibrillation compared to those with low apnoea-hypopnoea index and low hypoxic burden (adjusted odds ratio 1.97, 95% CI 1.25-3.12). In contrast, neither elevated apnoea-hypopnoea index nor high hypoxic burden alone demonstrated a statistically significant association. Elevated apnoea-hypopnoea index combined with high hypoxic burden identifies stroke patients at higher risk of atrial fibrillation. Integrating these metrics into post-stroke evaluation may improve personalized management and secondary prevention of recurrent cardiovascular or cerebrovascular events.
Date Issued
2026-08
Publication Type
Article
Subject(s)
Subjects
acute ischemic stroke
•
cardiac arrhythmias
•
sleep apnoea syndromes
Language(s)
en
Author(s)
Baillieul, Sebastien |
Journal
Journal of Sleep Research
Publisher
Wiley
ISSN
1365-2869
0962-1105
Access(Rights)
open.access