Right to Left Shunt and Cryptogenic Stroke in Patients Over 60 Years Old.

Publisher: Makedonska akademija na naukite i umetnostite Country of Publication: North Macedonia NLM ID: 101677081 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1857-8985 (Electronic) Linking ISSN: 18579345 NLM ISO Abbreviation: Pril (Makedon Akad Nauk Umet Odd Med Nauki) Subsets: MEDLINE

Original Publication: Skopje : Makedonska akademija na naukite i umetnostite, [2013]-

Foramen Ovale, Patent*/epidemiology ; Foramen Ovale, Patent*/complications ; Foramen Ovale, Patent*/diagnostic imaging ; Ischemic Attack, Transient*/epidemiology ; Ischemic Attack, Transient*/etiology ; Ultrasonography, Doppler, Transcranial*/methods; Humans ; Middle Aged ; Female ; Male ; Prospective Studies ; Aged ; Risk Factors ; Prevalence ; Age Factors ; Multivariate Analysis ; Odds Ratio ; Ultrasonography, Doppler, Color ; Case-Control Studies ; Ischemic Stroke/epidemiology ; Ischemic Stroke/etiology ; Stroke/epidemiology ; Stroke/etiology ; Logistic Models

Objective: To determine the possible role of patent foramen ovale (PFO) as indicated by a right to left shunt and cryptogenic stroke in patients aged ≥ 60 years and to compare the prevalence of patent foramen ovale with stroke of known cause.
Methods: We prospectively examined the prevalence of PFO using contrast enhanced colour Transcranial Doppler ultrasonography (bubble-cTCD) in 86 consecutive patients aged ≥60 years with transient ischaemic attack (TIA) or stroke and 86 consecutive patients aged <60 years with TIA/stroke as a control group. Patients with cryptogenic stroke were compared to stroke patients with known cause.
Results: A significantly higher prevalence of PFO in patients with cryptogenic compared to patients with stroke of known cause was registered in the patients aged < 60 years (56.6% vs.18.8%) and in patients aged ≥ 60 years (37.14% vs.11.76%), respectively. Multivariate analysis adjusted for age, hypertension and coronary disease showed that the existence of R-to-L shunt (RLS) was independently associated with cryptogenic stroke in both, in the younger group (odds ratio 4.012; 95% CI1.323 to 12.171, p =0.0143.70) and in the older group (odds ratio 3.197; 95% CI 1.140 to 10.877, p=0.037).
Conclusion: Our findings suggest that PFO is strongly associated with cryptogenic stroke in patients aged ≥ 60 years. Bubble - cTCD was feasible and suitable as a first-line method for the detection of PFO in older patients.
(© 2024 Sanja Djambazovska Zikova et al., published by Sciendo.)

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Keywords: cyptogenic stroke; patent foramen ovale; transcranial Doppler ultrasonography

Date Created: 20241212 Date Completed: 20241212 Latest Revision: 20250723

20250723

10.2478/prilozi-2024-0021

39667004