한빛사논문
- 조회264
Minyoul Baik, MD ,1,2 Chi Young Shim, MD, PhD ,3 Seo-Yeon Gwak, MD ,3 Young Dae Kim, MD, PhD ,1,4 Hyo Suk Nam, MD, PhD ,1,4 Hye Sun Lee, PhD ,5 Chung Mo Nam, PhD ,6 and Ji Hoe Heo, MD, PhD 1,4
From the 1Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; 2Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; 3Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea; 4Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Seoul, South Korea; 5Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea; and 6Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
Address correspondence to Dr Heo
Abstract
Objective
Patent foramen ovale (PFO) is often found in stroke patients with determined etiologies. PFO may be the actual cause of stroke in some of them. We determined whether the risk of recurrent ischemic stroke differs with PFO status in stroke patients with determined etiologies.
Methods
This study included consecutive patients with stroke of determined etiology who underwent transesophageal echocardiography. We compared the rates of recurrent cerebral infarction in patients with versus without PFO, and according to PFO-Associated Stroke Causal Likelihood (PASCAL) classification.
Results
Of 2,314 included patients, 827 (35.7%) had PFO. During a median follow-up of 4.4 years, cerebral infarction recurred in 202 (8.7%). In multivariate modified Cox regression analyses, recurrence of infarction did not significantly differ between patients with PFO and those without PFO (hazard ratio [HR] = 0.86, 95% confidence interval [CI] = 0.64–1.17, p = 0.339). Interaction analysis showed a significant effect of PFO in patients aged <65 years (adjusted p for interaction = 0.090). PFO was independently associated with a decreased risk of recurrent infarction in patients younger than 65 years (HR = 0.41, 95% CI = 0.20–0.85, adjusted p = 0.016). Patients with probable PFO-associated stroke on the PASCAL classification had a significantly lower risk of recurrent infarction than those without PFO (HR = 0.31, 95% CI = 0.10–0.97, p = 0.044).
Interpretation
Considering the generally low risk of recurrence in PFO-associated stroke, PFO may be the actual cause of stroke in some patients with determined etiologies, especially younger patients or those with PFO features of probable PFO-associated stroke. ANN NEUROL 2022;92:596–606
논문정보
- Research article
- 2022년 10월 (BRIC 등록일 2022-10-28)
- 국내 연구진
- 의약학 > 응용의학
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