Factors associated with patent foramen ovale-related stroke: SAFAS study.

Area of Science:

• Cardiology
• Neurology
• Biomarker Research

Background:

• Persistent foramen ovale (PFO) is a known contributor to cryptogenic stroke and stroke recurrence.
• The precise mechanisms linking PFO to ischemic events remain unclear.
• Limited data exists on the diagnostic value of biomarkers for PFO-related strokes.

Purpose of the Study:

• To investigate the association between PFO-related stroke and specific biomarkers.
• To identify potential biomarkers for diagnosing PFO-related strokes.
• To characterize the clinical and biological phenotype of patients with PFO-related cryptogenic stroke.

Main Methods:

• Prospective single-center study of ischemic stroke patients without a history of atrial fibrillation.
• Systematic PFO screening using transthoracic echocardiography with CLOSE trial criteria.
• Multivariate logistic regression analysis to assess the association of PFO-related stroke with biomarkers of cardiac fibrosis and inflammation (galectin-3, GDF-15, ST-2, osteoprotegerin, NT-proBNP).

Main Results:

• 10% of patients (23/229) had PFO-related stroke.
• PFO-related stroke patients were younger, had less hypertension, and more cerebellar involvement.
• Low galectin-3 (<9.5ng/mL) and osteoprotegerin (<1133pg/L) levels were independently associated with PFO-related stroke (OR 3.4 and 5.0, respectively).

Conclusions:

• Patients with cryptogenic stroke attributed to PFO exhibit a distinct clinical and biological profile.
• Low serum levels of galectin-3 and osteoprotegerin may serve as indicators for PFO-related strokes.
• These findings aid in identifying patients who may benefit from PFO evaluation.