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Modified Risk of Paradoxical Embolism More Effectively Evaluates the Risk of Stroke Associated with Patent Foramen

Yun Wang1, Tun Zhao1, Yajun Ma1

  • 1Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.

Current Neurovascular Research
|August 25, 2023
PubMed
Abstract

Insights

This study modified the Risk of Paradoxical Embolism (RoPE) score to better assess patent foramen ovale (PFO)-related stroke risk. Higher LDL-C and smaller left atrium size increase PFO-stroke risk, improving risk stratification.

Area of Science:

  • Neurology
  • Cardiology
  • Stroke Medicine

Background:

  • Patent foramen ovale (PFO) is a potential cause of ischemic stroke (IS).
  • Assessing the risk of PFO-related stroke (PS) is crucial for patient management.
  • The existing Risk of Paradoxical Embolism (RoPE) score requires refinement for better accuracy.

Purpose of the Study:

  • To identify independent risk factors for PFO-related stroke (PS).
  • To modify the RoPE scoring system by incorporating new risk factors.
  • To evaluate the enhanced RoPE score's performance in assessing PS risk.

Main Methods:

  • Retrospective analysis of ischemic stroke patients with PFO.
  • Classification into PS and non-PS groups based on clinical, laboratory, and imaging data.
  • Multivariate logistic regression to identify independent risk factors and develop a modified RoPE score.

Main Results:

  • Higher low-density lipoprotein-cholesterol (LDL-C) levels and smaller left atrium transverse diameter were significant risk factors for PS.
  • The modified RoPE score, incorporating LDL-C and left atrium size, showed improved discrimination (AUC 0.798) compared to the classical RoPE score (AUC 0.661).

Conclusions:

  • Elevated LDL-C and reduced left atrium transverse diameter are key independent risk factors for PS.
  • The modified RoPE scoring system demonstrates superior performance in assessing PS risk compared to the original score.
Keywords:
PFO-associated strokePatent foramen ovaleRisk of Paradoxical Embolismglobal burdenischemic strokerisk factor

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