0822 Association Between High Risk Of Obstructive Sleep Apnea And Intracranial Carotid Arterial Calcification In Acute Ischemic Stroke

Introduction Obstructive sleep apnea (OSA) is an independent risk factor for stroke. Further, intracranial artery calcification (ICAC) is a marker for subclinical atherosclerosis and future cardiovascular events. We investigated the association between ICAC and OSA in patients with acute ischemic stroke. Methods 1,163 patients were retrospectively analyzed. They were admitted to the hospital with an acute ischemic stroke, between June 2015 and November 2017. Among them, 585 patients had a high risk of OSA. Of these patients, we included those with a cerebral infarction in the unilateral middle cerebral artery (MCA) territory, which was classified as large artery atherosclerosis according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Patients were excluded if they did not have a unilateral MCA territory infarction, or had a cardioembolic stroke, or another etiology of stroke according to the TOAST classification. Two raters measured the semi-automatic quantitative Agatston score and calcium volume of intracranial internal carotid arteries on each image. The risk for OSA was assessed using the Berlin Questionnaire and patients were classified into either a low risk or high risk group. We compared the burden of arterial calcification between risk groups. Results Ultimately, 73 patients were enrolled in the study. The high risk for OSA group, comprising 35 (47.9%) patients, was significantly older, and had a higher rate of hypertension and diabetes mellitus than the low risk for OSA group. A multivariate analysis, controlling for demographics, sleep habit parameters, and traditional cardiovascular risk factors, revealed that high risk for OSA was associated with higher burden of ICAC, defined by the Agatston score on both the symptomatic (OR; 1.008, 95% CI; 1.001 to 1.016) and asymptomatic side (OR; 1.010, 95% CI; 1.002 to 1.017) of the internal carotid artery, and total calcium of both internal carotid arteries (OR; 1.006, 95% CI; 1.002 to 1.011). Conclusion This study showed that the high risk for OSA in patients with acute ischemic stroke due to intracranial cerebral atherosclerosis is associated with ICAC. Support (If Any)