Sleep Apnea-Predictor of Functional Outcome in Acute Ischemic Stroke

Nair, Radhika; Radhakrishnan, Kurupath; Chatterjee, Aparajita; Gorthi, Shankar Prasad; Prabhu, Varsha A

doi:10.1016/j.jstrokecerebrovasdis.2018.11.030

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…The increase in glucose and cholesterols is associated with the mechanism of compensation for the increased metabolic needs of the body as a whole, and especially the brain. A decrease in serum albumin, creatinine, as well as ALT activity, are predictors of functional outcomes acute stroke [ 48 , 49 ] and confirms the validity of the model.…”

Section: Discussionmentioning

confidence: 65%

Local Experimental Intracerebral Hemorrhage in Rats

et al. 2021

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(1) Background: Hemorrhagic stroke is a lethal disease, accounting for 15% of all stroke cases. However, there are very few models of stroke with a hemorrhagic etiology. Research work is devoted to studying the development of cerebrovascular disorders in rats with an intracerebral hematoma model. The aim of this study was to conduct a comprehensive short-term study, including neurological tests, biochemical blood tests, and histomorphological studies of brain structures. (2) Methods: The model was reproduced surgically by traumatizing the brain in the capsula interna area and then injecting autologous blood. Neurological deficit was assessed according to the McGrow stroke-index scale, motor activity, orientation–exploratory behavior, emotionality, and motor functions. On Day 15, after the operation, hematological and biochemical blood tests as well as histological studies of the brain were performed. (3) Results: The overall lethality of the model was 43.7%. Acute intracerebral hematoma in rats causes marked disorders of motor activity and functional impairment, as well as inflammatory processes in the nervous tissue, which persist for at least 14 days. (4) Conclusions: This model reflects the situation observed in the clinic and reproduces the main diagnostic criteria for acute disorders of cerebral circulation.

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Section: Discussionmentioning

confidence: 65%

Local Experimental Intracerebral Hemorrhage in Rats

et al. 2021

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“…Despite presenting with more cardiovascular conditions, AIS patients with OSA have been shown to present with less neurological injury at the time of hospital admission when compared to patients without OSA. [ 14 ] A recent study[ 15 ] also indicates poor functional outcome in AIS patients with OSA. However, in these studies,[ 14 15 ] AIS-OSA patients were not stratified based on initial stroke severities using initial NIHSS scores.…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and stroke severity: Impact of clinical risk factors

et al. 2021

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BACKGROUND: Specific clinical and demographic risk factors may be associated with improving or worsening neurologic outcomes within a population of acute ischemic stroke (AIS) patients with a history of obstructive sleep apnea (OSA). The objective of this study was to determine the changes in neurologic outcome during a 14-day recovery as it relates to initial stroke severity in AIS patients with OSA. METHODS: This retrospective study analyzed baseline clinical risk factors and demographic data collected in a regional stroke center from January 2010 to June 2016. Our primary endpoint measure was the National Institutes of Health Stroke Scale (NIHSS) score and our secondary endpoint measures included the clinical factors associated with improving (NIHSS score ≤7) or worsening (NIHSS score >7) neurological outcome. The relative contribution of each variable to stroke severity and related outcome was determined using a logistic regression. The regression models were checked for the overall correct classification percentage using a Hosmer–Lemeshow test, and the sensitivity of our models was determined by the area under the receiver operating characteristic curve. RESULTS: A total of 5469 AIS patients were identified. Of this, 96.89% did not present with OSA while 3.11% of AIS patients presented with OSA. Adjusted multivariate analysis demonstrated that in the AIS population with OSA, atrial fibrillation (AF) (odds ratio [OR] = 3.36, 95% confidence interval [CI], 1.289–8.762, P = 0.013) and changes in ambulatory status (OR = 2.813, 95% CI, 1.123–7.041, P = 0.027) showed an association with NIHSS score >7 while being Caucasian (OR = 0.214, 95% CI, 0.06–0.767, P = 0.018) was associated with NIHSS score ≤7. CONCLUSION: In AIS patients with OSA, AF and changes in ambulatory status were associated with worsening neurological outcome while Caucasian patients were associated with improving neurological outcome. Our findings may have significant implications for patient stratification when determining treatment protocols with respect to neurologic outcomes in AIS patients with OSA.

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“…Albumin is the major protein in human plasma and has generally been used as a quantitative measure of nutritional status. Recently, serum albumin concentrations were reported to be associated with increased risk for the development of myocardial infarction (MI), CAD, and stroke . Therefore, the ratio of GGT to albumin (GAR) may be a powerful predictor for cardiovascular disease outcomes.…”

Section: Introductionmentioning

confidence: 99%

Gamma‐glutamyl transferase to albumin ratio as a novel predictor of bleeding events and mortality in patients after percutaneous coronary intervention: A retrospective cohort study

Zheng

Wang

Chen

et al. 2020

Cathet Cardio Intervent

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Objectives To determine whether gamma‐glutamyl transferase (GGT) to albumin ratio (GAR) independently predicts mortality and bleeding events in coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI). Background Serum GGT and albumin levels have been associated with CAD risk and mortality. However, more analysis is needed to determine their predictive relationship with adverse outcomes. Methods In total, 5,638 patients from a large retrospective cohort study were enrolled from January 2008 to December 2016 and divided into two groups (GAR <0.62, n = 2,712 and GAR ≥0.62, n = 2,926). The average follow‐up time was 35.9 ± 22.6 months. Multivariate Cox regression analyses were performed to determine the risk of all‐cause mortality and bleeding events associated with GAR. Results The low‐GAR group had a significantly higher number of all‐cause mortality (p = .016) and bleeding events (p = .010) than the high‐GAR group. Multivariate Cox regression analyses showed that the risk of all‐cause death and bleeding events decreased by 23.8% (hazard risk [HR] = 0.762 95% confidence interval [CI]: 0.601–0.966, p = .025) and 39.4% (HR = 00.616, 95% CI: 0.446–0.852, p = .003), respectively, in the high‐GAR group. In patients with acute coronary syndrome, the risk of bleeding events decreased by 57.3% in the high‐GAR group (HR = 0.427, 95% CI: 0.234–0.781, p = .006). In patients with stable coronary heart disease, the risk of all‐cause death decreased 28.6% (HR = 0.714, 95% CI: 0.540–0.944, p = .018) in the high‐GAR group. Conclusion GAR was an independent and novel predictor of mortality and bleeding events in CAD patients who underwent PCI.

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Sleep Apnea-Predictor of Functional Outcome in Acute Ischemic Stroke

Cited by 14 publications

References 21 publications

Local Experimental Intracerebral Hemorrhage in Rats

Local Experimental Intracerebral Hemorrhage in Rats

Obstructive sleep apnea and stroke severity: Impact of clinical risk factors

Gamma‐glutamyl transferase to albumin ratio as a novel predictor of bleeding events and mortality in patients after percutaneous coronary intervention: A retrospective cohort study

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