Clinical & Experimental Cardiology
Open Access

Abstract

Anticoagulation and Paradoxical Protectors in Hypertrophic Cardiomyopathy with Sleep Apnea: Implications for Stroke Prevention

Yixuan Bao, Mingyue Hu, Lin Chen*, Weiwei Zeng*

This commentary examines the key findings and implications of the recent study by Chen et al., on stroke risk in patients with coexisting Hypertrophic Cardiomyopathy (HCM) and Sleep Apnea Syndrome (SAS). The original analysis of a national inpatient cohort revealed a stroke prevalence of 3.3% in this high-risk population and identified several independent risk factors, including female sex, hypertension, peripheral vascular disease, and Urinary Tract Infection (UTI). Notably, it also reported paradoxical inverse associations with obesity, Chronic Heart Failure (CHF), and anticoagulant use. This short commentary focuses on the most innovative aspects: The potential protective role of anticoagulation with overt Atrial Fibrillation (AF) and the clinical relevance of novel risk factors like UTI and the obesity paradox. We argue that these findings challenge conventional stroke risk stratification and underscore the need for integrated management and future prospective trials to refine prevention strategies in this vulnerable cohort.

Published Date: 2026-02-12; Received Date: 2026-01-13