OSA tied to higher risk of atrial fibrillation, stroke in morbidly obese patients

Morbidly obese patients are more likely to have atrial fibrillation (AF) and stroke in the presence of obstructive sleep apnoea (OSA), a study suggests.

The analysis included 827 morbidly obese patients (mean age 44 years, mean body mass index 49 kg/m²) who underwent laparoscopic adjustable gastric banding. Differences in bariatric surgery–induced weight loss on incident AF and stroke events were assessed between patients with and without OSA in the overall and propensity-matched cohorts.

Over a mean follow-up of 6.0 years, 4.96 percent and 5.44 percent of patients developed AF and stroke, respectively. While weight loss did not differ by OSA status (–19.6 percent vs –21 percent in 3 years), patients with vs without OSA had a higher incidence of new-onset AF both in the overall (1.7 percent vs 0.5 percent per year; p<0.001) and propensity-matched cohorts.

Likewise, the incidence of stroke was higher in the OSA than in the non-OSA group (2.10 percent vs 0.47 percent per year; p<0.001), but only 20 percent of patients with stroke had documented AF.

On multivariate Cox analysis, new-onset AF was predicted by OSA (hazard ratio [HR], 2.88, 95 percent confidence interval [CI], 1.45–5.73), age, and hypertension. Stroke, on the other hand, was associated with OSA (HR, 5.84, 95 percent CI, 3.02–11.30), depression, and body mass index.

More studies are needed to establish whether OSA treatment helps reduce AF or stroke events in the present population.