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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 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: Unique identifier: NCT00414583.
DOI: 10.1161/STROKEAHA.116.013620
ORCID: 0000-0002-6614-8417
PubMed URL: 27899752
Type: Journal Article
Subjects: MRI
Ischaemic Stroke
patent foramen ovale
Risk Factors
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