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Journal article

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

  • Kahles T Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Michel P Department of Neurology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
  • Hapfelmeier A Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University Munich, München, Germany.
  • Eberli FR Department of Cardiology, Municipal Hospital Triemli, Zurich, Switzerland.
  • Zedde M Department of Neurology, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy.
  • Thijs V Department of Neurology, University Hospitals of Leuven, Leuven, Belgium.
  • Kraemer M Department of Neurology, Alfried-Krupp Krankenhaus, Essen, Germany.
  • Engelter ST Department of Neurology, University Hospital of Basel, Basel, Switzerland.
  • Serena J Department of Neurology, University Hospital of Girona, Girona, Spain.
  • Weimar C Department of Neurology, University Hospital of Essen, Essen, Germany.
  • Mallmann A Department of Neurology, Klinikum Worms, Worms, Germany.
  • Luft A Department of Neurology, University Hospital of Zurich, Zurich, Switzerland.
  • Hemelsoet D Department of Neurology, University Hospital of Ghent, Ghent, Belgium.
  • Thaler DE Department of Neurology, Tufts Medical Center, Boston, MA, United States.
  • Müller-Eichelberg A Ammerland Klinik, Westerstede, Germany.
  • De Pauw A Department of Neurology, AZ Sint Blasius, Dendermonde, Belgium.
  • Sztajzel R Department of Neurology, University Hospital of Geneva, Geneva, Switzerland.
  • Armon C Department of Neurology, Baystate Health Center, Springfield, MA, United States.
  • Kent DM Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, United States.
  • Meier B Department of Cardiology, University Hospital of Bern, Bern, Switzerland.
  • Mattle HP Department of Neurology, University Hospital of Bern, Bern, Switzerland.
  • Fischer U Department of Neurology, University Hospital of Bern, Bern, Switzerland.
  • Arnold M Department of Neurology, University Hospital of Bern, Bern, Switzerland.
  • Mono ML Department of Neurology, University Hospital of Bern, Bern, Switzerland.
  • Nedeltchev K Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland.
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  • 2020-06-26
Published in:
  • Frontiers in neurology. - 2020
English 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.
Language
  • English
Open access status
gold
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Persistent URL
https://sonar.ch/global/documents/210223
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