| Spontaneous large right-to-left shunt and migraine headache with aura are risk factors for recurrent stroke in patients with a patent foramen ovale. | |
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MedLine Citation:
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PMID: 17166607 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We sought to determine whether migraine headache with aura (MHA) and spontaneous large right-to-left (R-L) shunt are risk factors for recurrent cerebral ischemic events in cryptogenic stroke patients with a patent foramen ovale (PFO). METHODS: 140 patients with a PFO and cryptogenic stroke underwent transcatheter defect closure at our institution at a mean age of 45+/-13 years. We retrospectively analyzed follow-up data from the first cerebral ischemic event to the time of PFO closure. Before the procedure, all patients underwent transesophageal echocardiography (TEE); Transcranial Doppler scanning (TCD) was additionally performed on the last 59 patients. We analyzed the impact of MHA, thrombophilia, spontaneous large R-L shunt, and atrial septal aneurysm (ASA) on the risk of recurrent cerebral ischemic events. RESULTS: 44 patients (31%) had had at least 1 recurrent event during a follow-up of 2.2+/-2.6 years. Patients with recurrent events were more commonly females (p=0.0001), had more often an associated thrombophilia (p=0.0077), and had a higher prevalence of spontaneously large R-L shunt both at TEE and at TCD (p<0.05). They also had more commonly a history of MHA (p=0.0009) and more frequent episodes of MHA (p=0.0048). Patients with MHA had a higher risk of recurrent events when compared to patients without (odds ratio 3.87, 95% CI 1.75 to 8.50). Thrombophilia (p=0.001) and spontaneous large R-L shunt (p=0.02) were independent predictors of recurrent stroke. CONCLUSIONS: In cryptogenic stroke patients with a PFO, a history of MHA, large spontaneous large R-L shunt, and thrombophilia are all associated with a higher risk of recurrent events. |
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Authors:
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Alessandro Giardini; Andrea Donti; Roberto Formigari; Luisa Salomone; Gualtiero Palareti; Donata Guidetti; Fernando Maria Picchio |
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Publication Detail:
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Type: Journal Article Date: 2006-12-12 |
Journal Detail:
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Title: International journal of cardiology Volume: 120 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-07-23 Completed Date: 2007-10-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 357-62 Citation Subset: IM |
Affiliation:
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Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Italy. alessandro5574@iol.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Female Heart Septal Defects, Atrial / complications*, surgery Humans Ischemic Attack, Transient / complications* Male Middle Aged Migraine with Aura / complications* Multivariate Analysis Recurrence Retrospective Studies Risk Factors Sex Factors Stroke / complications* Thrombophilia / complications |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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