High-risk patent foramen ovale and elderly in cryptogenic stroke

Area of Science:

• Cardiology
• Neurology
• Echocardiography

Background:

• Patent foramen ovale (PFO) is a potential cause of cryptogenic stroke (CS).
• Clinical characteristics of high-risk PFO, especially in elderly patients, require further investigation.

Purpose of the Study:

• To investigate the clinical characteristics of high-risk PFO in cryptogenic stroke patients.
• To compare these characteristics across different PFO risk groups and age demographics.

Main Methods:

• Analysis of 654 cryptogenic stroke patients from the CHALLENGE ESUS/CS registry.
• Categorization into high-risk PFO, right-to-left shunt (RLS), and no-RLS groups based on PFO characteristics and atrial septal aneurysm (ASA).
• Multinomial logistic regression used to identify independent associations.

Main Results:

• Male sex was associated with high-risk PFO.
• Hypertension, multiple infarcts, and other cardioembolic risks were inversely associated with high-risk PFO compared to no-RLS.
• These inverse associations persisted in patients aged 60 years and older.

Conclusions:

• High-risk PFO exhibits specific clinical features in CS patients.
• The observed clinical profile of high-risk PFO is consistent in elderly CS patients (≥60 years).