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26-A-16473-ACC IMPACT OF SLEEP APNEA ON CARDIOVASCULAR EVENTS AFTER STROKE: A PROPENSITY-MATCHED ANALYSIS USING TRINETX
Abstract   Peer reviewed

26-A-16473-ACC IMPACT OF SLEEP APNEA ON CARDIOVASCULAR EVENTS AFTER STROKE: A PROPENSITY-MATCHED ANALYSIS USING TRINETX

God-dowell O. Odukudu, Divine Dele, Ademola Ajibade, Ephesians Nkwetta Anutebeh, Ogheneakpobor Ubogun, Omowunmi Fakorede, Innocent Lutaya, Francois Barrett, Chinelo Madekwe, Henry Ariri, …
Journal of the American College of Cardiology, Vol.87(13 Supplement), p.A320
04/2026
DOI: 10.1016/j.jacc.2026.02.792

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Abstract

Stroke is a leading cause of death and disability, with obstructive sleep apnea (OSA) affecting up to 90% of post-stroke patients. OSA drives cardiovascular risk through hypoxemia, inflammation, endothelial dysfunction, and sympathetic activation, promoting hypertension, arrhythmias, and atherosclerosis. Methods This retrospective cohort study used TriNetX Research Network data to identify adult patients (18-99 years) with stroke, comparing those with and without obstructive sleep apnea. Propensity score matching balanced cohorts for demographics and major comorbidities (age, sex, race, hypertension, atrial flutter/fibrillation), with primary outcomes of 1-year all-cause mortality and secondary outcomes including acute heart failure, readmission, cardiac arrest, myocardial infarction, and sick-sinus syndrome. Results After matching 174,464 stroke patients with and without OSA, OSA was associated with lower 1-year mortality (10.1% vs. 11.8%; HR, 0.82; p < 0.001). However, OSA patients had higher risks of acute heart failure and sick sinus syndrome, with modestly higher hospitalization and recurrent stroke rates. Myocardial infarction rates were slightly lower, and cardiac arrest rates were comparable between groups. Conclusion This study suggests a survival advantage in post-stroke patients with OSA despite higher rates of heart failure and arrhythmias, underscoring the need for systematic screening, treatment, and prospective studies.

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