Edrissi Camron, Rathfoot Chase, Knisely Krista, Sanders Carolyn Breauna, Poupore Nicolas, Nathaniel Thomas
University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, United States.
University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, United States.
J Vasc Nurs. 2022 Mar;40(1):17-27. doi: 10.1016/j.jvn.2021.10.002. Epub 2021 Oct 27.
Differences in baseline clinical risk factors have been proposed to contribute to gender differences in stroke outcome, how these clinical risk factors contribute to gender difference in acute ischemic stroke (AIS) patients with obstructive sleep apnea is yet to be fully investigated. This study explored the clinical characteristics associated with gender differences in AIS population with a baseline obstructive sleep apnea(OSA).
A retrospective study was conducted using data from 5469 patients with an ischemic stroke event from a regional stroke center collected from January 2010 to June 2016. Multivariate logistic regression was used to determine factors associated with gender differences in the obstructive sleep apnea-ischemic stroke population.
A total of 170 AIS patients presented with a baseline OSA, and 101 were men and 69 were women. In the AIS with OSA (AIS-OSA) population, patients presenting with peripheral vascular disease (PVD) (OR = 4.892, 95% CI,1.248 - 19.2, P = 0.023), depression (OR = 3.804, 95% CI, 1.369 - 10.6, P = 0.01), higher BMI (OR = 1.103, 95% CI, 1.036 - 1.18, P = 0.002), and higher HDL levels (OR = 1.125, 95% CI, 1.067 - 1.19, P = < 0.001) were associated with increasing odds of being women, and no clinical risk factor was associated with men AIS-OSA patients.
A gender specific difference was observed in pre-stroke demographic and risk factors for AIS patients with OSA. Women AIS patients with OSA were more likely to present with PVD and depression and have higher HDL and BMI levels when compared to men within the same population. In addition, more men AIS presented with OSA when compared with women AIS patients. Further studies to explore management strategies to eliminate gender differences will improve outcomes for men and women AIS with OSA.
已有研究提出基线临床风险因素的差异可能导致卒中结局存在性别差异，但这些临床风险因素如何导致合并阻塞性睡眠呼吸暂停的急性缺血性卒中（AIS）患者出现性别差异，仍有待充分研究。本研究探讨了合并基线阻塞性睡眠呼吸暂停（OSA）的AIS人群中与性别差异相关的临床特征。
采用回顾性研究方法，分析了2010年1月至2016年6月从某地区卒中中心收集的5469例缺血性卒中患者的数据。采用多因素logistic回归分析确定阻塞性睡眠呼吸暂停合并缺血性卒中人群中与性别差异相关的因素。
共有170例AIS患者存在基线OSA，其中男性101例，女性69例。在合并OSA的AIS（AIS-OSA）人群中，患有外周血管疾病（PVD）的患者（OR = 4.892，95%CI，1.248 - 19.2，P = 0.023）、抑郁症患者（OR = 3.804，95%CI，1.369 - 10.6，P = 0.01）、BMI较高者（OR = 1.103，95%CI，1.036 - 1.18，P = 0.002）以及HDL水平较高者（OR = 1.125，95%CI，1.067 - 1.19，P = < 0.001）为女性的可能性增加，且没有临床风险因素与男性AIS-OSA患者相关。
在合并OSA的AIS患者的卒中前人口统计学和风险因素方面观察到了性别特异性差异。与同一人群中的男性相比，合并OSA的女性AIS患者更有可能患有PVD和抑郁症，且HDL和BMI水平更高。此外，与女性AIS患者相比，男性AIS合并OSA的情况更多。进一步研究探索消除性别差异的管理策略将改善合并OSA的男性和女性AIS患者的结局。
