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Title: | Patent Foramen Ovale and Cryptogenic Strokes in the Stroke in Young Fabry Patients Study. | Austin Authors: | Huber, Roman;Grittner, Ulrike;Weidemann, Frank;Thijs, Vincent N ;Tanislav, Christian;Enzinger, Christian;Fazekas, Franz;Wolf, Markus;Hennerici, Michael G;McCabe, Dominick J H;Putaala, Jukaa;Tatlisumak, Turgut;Kessler, Christoph;von Sarnowski, Bettina;Martus, Peter;Kolodny, Edwin;Norrving, Bo;Rolfs, Arndt | Affiliation: | Department for Biostatistics and Clinical Epidemiologyand Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany Department of Neurology, Medical Campus Lake Constance, Klinikum Friedrichshafen, Germany Department of Neurology, University of Ulm, Ulm, Germany Department of Internal Medicine II, Katharinen Hospital, Unna, Germany Department of Neurology, Austin Health, Heidelberg, Victoria, Australia Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia Department of Neurology, Justus Liebig University Giessen, Germany Department of Neurologyand Clinical Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria Department of Neurology, University of Mannheim, Germany Department of Neurology and Stroke Service, The Adelaide and Meath Hospital, incorporating the National Children's Hospital, Dublin, Ireland Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, London, United Kingdom Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland Department of Neurology, Helsinki University Central Hospital, Finland Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden Department of Neurology, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Germany Department of Epidemiology and Biometrics, University of Tübingen, Germany Department of Neurology, New York University School of Medicine Department of Clinical Sciences, Section of Neurology, Lund University, Sweden Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Germany |
Issue Date: | Jan-2017 | Date: | 2016-11-29 | Publication information: | Stroke 2017; 48(1): 30-35 | Abstract: | A patent foramen ovale (PFO) is disproportionately prevalent in patients with cryptogenic stroke. Without alternative explanations, it is frequently considered to be causative. A detailed stratification of these patients may improve the identification of incidental PFO. We investigated the PFO prevalence in 3497 transient ischemic attack and ischemic stroke patients aged 18 to 55 years in the prospective multicenter SIFAP1 study (Stroke in Young Fabry Patients 1) using the ASCO classification. Patients without an obvious cause for transient ischemic attack/stroke (ASCO 0) were divided into subgroups with and without vascular risk factors (ASCO 0+ and 0-). In addition, we looked for PFO-related magnetic resonance imaging lesion patterns. PFO was identified in 25% of patients. Twenty percent of patients with a definite or probable cause of transient ischemic attack/stroke (≥1 grade 1 or 2 ASCO criterion; n=1769) had a PFO compared with 29% of cryptogenic stroke patients (ASCO 0 and 3; n=1728; P<0,001); subdivision of cryptogenic strokes revealed a PFO in 24% of 978 ASCO 3 patients (n.s. versus ASCO 1 and 2) and a higher prevalence of 36% in 750 ASCO 0 cases (P<0.001 versus ASCO 3 and versus ASCO 1 and 2). PFO was more commonly observed in ASCO 0- (n=271) than in ASCO 0+ patients (n=479; 48 versus 29%; P<0.001). There was no PFO-associated magnetic resonance imaging lesion pattern. Cryptogenic stroke patients demonstrate a heterogeneous PFO prevalence. Even in case of less conclusive diseases like nonstenotic arteriosclerosis, patients should preferentially be considered to have a non-PFO-mediated stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/19123 | DOI: | 10.1161/STROKEAHA.116.013620 | ORCID: | 0000-0002-6614-8417 | Journal: | Stroke | PubMed URL: | 27899752 | Type: | Journal Article | Subjects: | MRI arteriosclerosis Ischaemic Stroke patent foramen ovale Risk Factors |
Appears in Collections: | Journal articles |
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