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Is obstructive sleep apnea associated with the presence of intracranial cerebral atherosclerosis?

Is obstructive sleep apnea associated with the presence of intracranial cerebral atherosclerosis?
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Song TJ, Park JH, Choi KH, Kim JH, Choi Y, Chang Y, Kim HJ, Moon J, Kim YJ, Lee HW,


Song TJ, Park JH, Choi KH, Kim JH, Choi Y, Chang Y, Kim HJ, Moon J, Kim YJ, Lee HW, (click to view)

Song TJ, Park JH, Choi KH, Kim JH, Choi Y, Chang Y, Kim HJ, Moon J, Kim YJ, Lee HW,

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Sleep & breathing = Schlaf & Atmung 2017 02 07() doi 10.1007/s11325-016-1450-9
Abstract
PURPOSE
Intracranial cerebral atherosclerosis (ICAS) is one of critical atherosclerosis which closely related with stroke. Obstructive sleep apnea (OSA) is associated with systemic atherosclerosis, but it is unclear whether OSA is related with the presence of ICAS. We aimed to investigate the association between the presence of ICAS and severity of OSA in patients with suspected OSA.

METHODS
This retrospective, cross-sectional study included 283 patients who suspected OSA (presence of one or more OSA-related symptom and high-risk category in Berlin questionnaire) and underwent polysomnography and brain magnetic resonance angiography (MRA). The ICAS was defined as ≥50% decrease of luminal diameter in MRA. The severity of OSA was defined by apnea-hypopnea index (AHI).

RESULTS
The mean age was 60.7 ± 13.5 years, and 55.8% (158/283) were male in all included patients. The 53 (18.7%) patients had ICAS and 117 (41.3%) patients had moderate to severe OSA (AHI ≥ 15). Higher AHI was noted in patients with ICAS compared to those without ICAS (31.7 ± 25.8 versus 15.2 ± 17.4, p = 0.001). In multivariable logistic analyses, after adjusting for age, sex, and variables with p < 0.1 in univariable analyses (hypertension, diabetes mellitus, atrial fibrillation, previous stroke history, body mass index, lipid-lowing agents, arousal index, and minimum oxygen saturation), moderate to severe OSA were independently related with the presence of ICAS (odds ratio 4.17, 95% confidence interval 1.40-12.40, p = 0.010). CONCLUSIONS
Our findings suggest that moderate to severe OSA is associated with the presence of ICAS in patients with suspected OSA.

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