The Correlation Between OSAHS And Ischemic Stroke:a Systematic Review

Objective: To assess the correlation between obstructive sleep apnea-hypopnea syndrome(OSAHS) and ischemic stroke. Methods:Such databases as PubMed(1966 to September 2014), EMbase(1966 to September 2014), MEDLINE(1966 to September 2014), the Cochrane Library(2009 to September 2014), BIOSISP review (1990 to September 2014), CBM(1979 to September 2014), VIP(1989 to September 2014), WANFANG(1977 to September 2014),and CNKI (1979 to September 2014) were searched to collect literatures about the correlation between OSAHS and ischemic stroke, and manual retrieval the related literature. All cohort studies and case control studies were included. Reviewers collected the data, assessed the quality, and conducted the Meta-analysis by using RevMan5.3 software, and make respective Meta-analysis according to the different type of studies and different grade of OSAHS, evaluated the correlation between OSAHS and ischemic stroke and the correlation is whether related to different grade of OSAHS. Assess the literature published off-set. Use the GRADE pro3.6 to assess the quality of evidence. Results:We totally searched out 2012 related literatures. The first selected we include 95 literatures, and finally 20 literatures. In all the included literatures there are 8 cohort studies, totally 10567 participants. Other 12 literatures are case control studies, totally 9668 participants. The results of Meta-analyses showed that: the OSAHS was correlated with ischemic stroke (OR=4.62,95% CI=[3.71,5.76], P<0.000 01); Subgroup analyses were performed according to the type study. The results of cohort studys and case-control studies showed that:RR=3.01,95% CI=[2.35,3.86], <0.00001; OR=4.25,95% CI=[3.78,4.79],P<0.00001. The results showed that there was a correlation between OSAHS and ischemic stroke. Subgroup analyses were performed according to the severity of OSAHS, the results showed that:there was no correlation between the mild OSAHS and ischemic stroke (RR=0.63,95% CI=[0.14,2.75], P=0.54; OR=0.45,95% CI=[0.19,1.08], P=0.08); there might be a correlation between the moderate or severe OSAHS and ischemic stroke(RR=4.85,95% CI=[1.91,12.35], P=0.0009; OR=1.51,95% CI=[0.66,3.46], P=0.33; OR=3.44,95% CI=[1.21,9.78], P=0.02). Conclusion:OSAHS is significantly related to ischemic stroke and they maybe the mutual risk factor for each other. The correlation between OSAHS and ischemic stroke may be related with different grades of OSAHS:participants maybe more likely to have ischemic stroke if the OSAHS is more severe.