Fibrinogen, stroke and obstructive sleep apnea

Patients with ischemic stroke and obstructive sleep apnea (OSA) have elevated fibrinogen levels which correlate positively with apnea severity.

By | December 14, 2000

Patients with ischemic stroke and obstructive sleep apnea (OSA) have elevated fibrinogen levels, which correlate positively with apnea severity, suggest Wessendorf et al in a paper published in the December issue of American Journal of Respiratory and Critical Care Medicine (Am J Respir Crit Care Med 2000 162:2039-2042).

OSA is prevalent in patients with stroke but the mechanisms involved are not clear. One hypothesis is that disturbances in inflammatory cytokines and fibrinogen mediate cardiovascular pathophysiology in OSA. Dr Thomas Wessendorf and colleagues from the University of Essen in Germany studied 113 patients with ischaemic stroke to determine the association between OSA and plasma levels of fibrinogen. They found that fibrinogen levels were significantly higher in patients with more severe respiratory disturbance and longer apnea during sleep. Patients with any evidence of infection as determined by an elevated erythrocyte sedimentation rate were excluded from the start.

The investigators postulate that soft palate inflammation may contribute to upper airway occlusion during sleep. These data raise the speculative but provocative possibility that airway inflammation associated with OSA may increase fibrinogen levels and thus increase the risk of stroke.

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