Fibrinogen Levels and Obstructive Sleep Apnea in Ischemic Stroke

Abstract

The plasma level of fibrinogen is felt to be an independent risk factor for vascular events. Obstructive sleep apnea (OSA) has a high prevalence in patients with stroke and may also be an independent risk factor. The aim of our study was to determine the association between OSA and plasma levels of fibrinogen in patients with stroke. Polysomnography was performed during neurological rehabilitation in 113 patients (82 men, 31 women, age 58 +/- 11.1 yr, mean +/- SD) with ischemic stroke. OSA was absent (RDI < 5) in 44 patients, 42 had mild OSA (5 < or = RDI < 20), and 27 had moderate to severe OSA (RDI > or = 20). Parameters of OSA (respiratory disturbance index [RDI], oxygen indices) were correlated to plasma levels of fibrinogen, measured in the morning after admission to rehabilitation. Fibrinogen was positively correlated with RDI (r = 0.24, p = 0.007), duration of the longest apnea (r = 0.18, p = 0.049), and negatively correlated with several oxygen indices including average minimal oxygen saturation (r = -0.41, p < 0.001). Correlation coefficients were slightly higher when excluding patients with stroke of presumed cardiac origin. Multiple linear regression identified minimal mean oxygen saturation and sex as independent predictors of fibrinogen level. The correlation between severity of coexisting OSA and fibrinogen level in patients with stroke suggests a possible pathophysiological mechanism for an increased risk of stroke in patients with OSA.

The Combination of Supplemental Oxygen and a Hypnotic Markedly Improves Obstructive Sleep Apnea in Patients with a Mild to Moderate Upper Airway Collapsibility

“…Obstructive sleep apnea (OSA) is a highly prevalent disorder with serious cardiovascular [1][2][3][4][5][6][7][8] and neurocognitive consequences, 9 yet a considerable number of patients do not tolerate the most commonly prescribed treatment, continuous positive airway pressure (CPAP). [10][11][12][13][14][15] Therefore, novel approaches to OSA treatments are needed.…”

The rheological properties of blood and the risk of cardiovascular disease in patients with obstructive sleep apnea syndrome (OSAS)

“…Wessendorf et al [20] showed that elevated plasma fibrinogen levels in stroke patients are accompanied by a higher incidence of OSA. Their data confirmed a positive correlation between the plasma fibrinogen concentration and the number and duration of recorded breathing disorders during sleep, and a negative correlation with minimum and average blood saturation.…”

Gedeihstörung bei Hypoventilation im Schlaf

“…Im Vordergrund stehen kardiovaskuläre Überlastung [1], hormonelle Störungen [2][3][4] und neurokognitiver Abbau [5]. Aber auch metabolische Störungen der Gerinnung [6] und des Fettstoffwechsels [7,8] …”