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

Authors :
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 NCT
Source :
Frontiers in Neurology, Vol 11 (2020)
Publication Year :
2020
Publisher :
Frontiers Media S.A., 2020.

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.

Details

Language :
English
ISSN :
16642295
Volume :
11
Database :
Directory of Open Access Journals
Journal :
Frontiers in Neurology
Publication Type :
Academic Journal
Accession number :
edsdoj.6b4abb56191a49fea277ec3088b02b19
Document Type :
article
Full Text :
https://doi.org/10.3389/fneur.2020.00503