1. Prior Stroke in PFO Patients Is Associated With Both PFO-Related and -Unrelated Factors
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Timo Kahles, Patrik Michel, Alexander Hapfelmeier, Franz R. Eberli, Marialuisa Zedde, Vincent Thijs, Markus Kraemer, Stefan T. Engelter, Joaquin Serena, Christian Weimar, Achim Mallmann, Andreas Luft, Dimitri Hemelsoet, David E. Thaler, Andreas Müller-Eichelberg, Adinda De Pauw, Roman Sztajzel, Carmel Armon, David M. Kent, Bernhard Meier, Heinrich P. Mattle, Urs Fischer, Marcel Arnold, Marie-Luise Mono, Krassen Nedeltchev, for the International PFO Consortium NCT00859885, and International PFO Consortium NCT00859885
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medicine.medical_specialty ,RECURRENT CEREBRAL-ISCHEMIA ,patent foramen ovale ,medicine.medical_treatment ,Right-to-left shunt ,Clinical Neurology ,prior stroke ,Medizin ,610 Medicine & health ,030204 cardiovascular system & hematology ,lcsh:RC346-429 ,International PFO Consortium ,MEDICAL THERAPY ,PFO ,cryptogenic stroke ,hypercholesterolemia ,right-to-left shunt ,risk factor ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,medicine.artery ,Internal medicine ,Medicine and Health Sciences ,medicine ,Valsalva maneuver ,ATTACK ,cardiovascular diseases ,METAANALYSIS ,lcsh:Neurology. Diseases of the nervous system ,Original Research ,OLDER ,RISK ,CRYPTOGENIC STROKE ,business.industry ,Odds ratio ,medicine.disease ,PERCUTANEOUS CLOSURE ,Pulmonary embolism ,Venous thrombosis ,Neurology ,Patent foramen ovale ,Cardiology ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background and Purpose: To identify factors associated with prior stroke at presentation in patients with cryptogenic stroke (CS) and patent foramen ovale (PFO). Methods: We studied cross-sectional data from the International PFO Consortium Study (NCT00859885). Patients with first-ever stroke and those with prior stroke at baseline were analyzed for an association with PFO-related (right-to-left shunt at rest, atrial septal aneurysm, deep venous thrombosis, pulmonary embolism, and Valsalva maneuver) and PFO-unrelated factors (age, gender, BMI, hypertension, diabetes mellitus, hypercholesterolemia, smoking, migraine, coronary artery disease, aortic plaque). A multivariable analysis was used to adjust effect estimation for confounding, e.g., owing to the age-dependent definition of study groups in this cross-sectional study design. Results: We identified 635 patients with first-ever and 53 patients with prior stroke. Age, BMI, hypertension, diabetes mellitus, hypercholesterolemia, coronary artery disease, and right-to-left shunt (RLS) at rest were significantly associated with prior stroke. Using a pre-specified multivariable logistic regression model, age (Odds Ratio 1.06), BMI (OR 1.06), hypercholesterolemia (OR 1.90) and RLS at rest (OR 1.88) were strongly associated with prior stroke.Based on these factors, we developed a nomogram to illustrate the strength of the relation of individual factors to prior stroke. Conclusion: In patients with CS and PFO, the likelihood of prior stroke is associated with both, PFO-related and PFO-unrelated factors. CA extern
- Published
- 2020
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