Search

Your search keyword '"Achim Mallmann"' showing total 3 results
Start Over Author "Achim Mallmann"
3 results on '"Achim Mallmann"'

1. Prior Stroke in PFO Patients Is Associated With Both PFO-Related and -Unrelated Factors

Author

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, and for the International PFO Consortium NCT

Subjects
patent foramen ovale, PFO, right-to-left shunt, cryptogenic stroke, prior stroke, risk factor, Neurology. Diseases of the nervous system, RC346-429
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.

Published
2020
Full Text
View/download PDF

2. Abstract 208: Vascular Risk Factors But Not Transesophageal Echocardiography (TEE) Features Are Associated With Stroke Recurrence in Patients With Cryptogenic Stroke (CS) and Patent Foramen Ovale (PFO)

Author

Marie-Luise Mono, Timo Kahles, David E. Thaler, Patrik Michel, Christian Weimar, Joaquin Serena, Vincent Thijs, Stefan Engelter, Markus Krämer, Andreas Luft, Franz Eberli, Achim Mallmann, Andreas Müller-Eichelberg, Lester Collins, Dimitri Hemelsoet, Maria Luisa Zedde, Adinda De Pauw, Carmel Armon, Marcel Arnold, Bernhard Meier, Heinrich P. Mattle, and Krassen Nedeltchev

Subjects
Advanced and Specialized Nursing, Neurology (clinical), Cardiology and Cardiovascular Medicine
Abstract

Background and purpose: Recurrent ischemic stroke in patients with CS and PFO has been proposed as a marker of increased risk for paradoxical embolism. It is unclear, whether the excess risk is driven by specific features of the PFO (right-to-left shunt (RLS) size, RLS at rest, associated atrial septum aneurysm (ASA)) or the presence of vascular risk factors (vRF). We compare the prevalence of vRF, TEE features, and baseline medications in PFO patients with first-ever versus multiple CS. Methods: From September 2008 to March 2013, the International PFO Consortium enrolled 993 patients with ischemic stroke or transient ischemic attack (TIA) and newly diagnosed PFO. In this analysis of baseline data, we included 386 patients with first-ever CS and no radiological evidence of prior cerebral ischemia (first-ever CS group, mean age, 52y) as well as 71 patients with recurrent CS and multiple ischemic lesions on CT and/or MRI (multiple CS group, mean age, 59y). Patients with TIA as index event, those with first-ever CS but additional “silent” ischemic lesions on imaging as well as those with recurrent CS without radiological findings of prior cerebral ischemia were excluded. We used nonparametric tests for independent samples and the Bonferroni correction for multiple comparisons. Results: Age > 55y (63% vs. 44%, P=0.001), hypertension (52% vs. 30%, P=0.001), hyperlipidemia (64% vs. 44%, P=0.003), and coronary artery disease (15% vs. 3%, P=0.001) were significantly more frequent in the multiple CS than in the first-ever CS group. The frequencies of male gender, current smoking, diabetes, migraine with or without aura, associated ASA, RLS size, and RLS at rest did not differ between groups. At baseline, patients with multiple CS were more likely to be on antiplatelets (50% vs. 18%), antihypertensive (51% vs. 22%) or lipid lowering drugs (44% vs. 10%, P=0.001 for each comparison) than patients with first-ever CS. The frequency of anticoagulant treatment did not differ between groups. Conclusions: In patients with CS, vRF but not specific PFO features were associated with recurrent cerebral ischemic events. The ongoing prospective part of the International PFO Consortium will likely shed light upon the role of vRF control for secondary stroke prevention in patients with PFO.

Published
2015
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results