Patent foramen ovale and stroke: Difference between revisions
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Although, two prospective cohort studies namely, ‘ [[The Northern Manhattan Study]]’ ([[NOMAS]]) <ref name="pmid17306710">{{cite journal| author=Di Tullio MR, Sacco RL, Sciacca RR, Jin Z, Homma S| title=Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. | journal=J Am Coll Cardiol | year= 2007 | volume= 49 | issue= 7 | pages= 797-802 | pmid=17306710 | doi=10.1016/j.jacc.2006.08.063 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17306710 }} </ref> and '[[Stroke Prevention: Assessment of Risk in a Community]]' ([[SPARC]]) <ref name="pmid16412874">{{cite journal| author=Meissner I, Khandheria BK, Heit JA, Petty GW, Sheps SG, Schwartz GL et al.| title=Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study. | journal=J Am Coll Cardiol | year= 2006 | volume= 47 | issue= 2 | pages= 440-5 | pmid=16412874 | doi=10.1016/j.jacc.2005.10.044 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412874 }} </ref>, found an increased incidence of first [[stroke]] in patients with [[patent foramen ovale]], both these studies did not reach a statistical significance. | Although, two prospective cohort studies namely, ‘ [[The Northern Manhattan Study]]’ ([[NOMAS]]) <ref name="pmid17306710">{{cite journal| author=Di Tullio MR, Sacco RL, Sciacca RR, Jin Z, Homma S| title=Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. | journal=J Am Coll Cardiol | year= 2007 | volume= 49 | issue= 7 | pages= 797-802 | pmid=17306710 | doi=10.1016/j.jacc.2006.08.063 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17306710 }} </ref> and '[[Stroke Prevention: Assessment of Risk in a Community]]' ([[SPARC]]) <ref name="pmid16412874">{{cite journal| author=Meissner I, Khandheria BK, Heit JA, Petty GW, Sheps SG, Schwartz GL et al.| title=Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study. | journal=J Am Coll Cardiol | year= 2006 | volume= 47 | issue= 2 | pages= 440-5 | pmid=16412874 | doi=10.1016/j.jacc.2005.10.044 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412874 }} </ref>, found an increased incidence of first [[stroke]] in patients with [[patent foramen ovale]], both these studies did not reach a statistical significance. | ||
==[[Patent foramen ovale]] and recurrent [[stroke]]== | |||
There exists a discrepancy between influences of [[patent foramen ovale]] ([[PFO]]) on recurrent [[stroke]] (after [[Paradoxical embolism|cryptogenic stroke]]). Several factors have been found associated with a [[patent foramen ovale]] ([[PFO]]) that might increase the incidence of recurrent [[strokes]] namely, ASA in association with [[PFO]], bigger shunts, longer tunnels. Nevertheless, some studies have found no association between [[PFO]] or abnormal septal morphology with recurrent [[strokes]]. | |||
==References== | ==References== | ||
Revision as of 14:41, 5 September 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [3]
Overview
Association of cryptogenic stroke/transient ischemic attacks with patent foramen ovale
- One in every four cases of ischemic stroke does not have an identifiable cause other than cryptogenic stroke which is a diagnosis of exclusion[1].
- Cryptogenic stroke occurs more commonly in younger patients.
- The association between the presence of a patent foramen ovale and cryptogenic stroke is controversial and inconsistent. While some studies have demonstrated an increased incidence of patent foramen ovale (PFO) in younger patients with cryptogenic stroke [2] others failed to show an association [3].
Patent foramen ovale and first stroke
Although, two prospective cohort studies namely, ‘ The Northern Manhattan Study’ (NOMAS) [4] and 'Stroke Prevention: Assessment of Risk in a Community' (SPARC) [5], found an increased incidence of first stroke in patients with patent foramen ovale, both these studies did not reach a statistical significance.
Patent foramen ovale and recurrent stroke
There exists a discrepancy between influences of patent foramen ovale (PFO) on recurrent stroke (after cryptogenic stroke). Several factors have been found associated with a patent foramen ovale (PFO) that might increase the incidence of recurrent strokes namely, ASA in association with PFO, bigger shunts, longer tunnels. Nevertheless, some studies have found no association between PFO or abnormal septal morphology with recurrent strokes.
References
- ↑ Sacco RL, Ellenberg JH, Mohr JP, Tatemichi TK, Hier DB, Price TR; et al. (1989). "Infarcts of undetermined cause: the NINCDS Stroke Data Bank". Ann Neurol. 25 (4): 382–90. doi:10.1002/ana.410250410. PMID 2712533.
- ↑ Overell JR, Bone I, Lees KR (2000). "Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies". Neurology. 55 (8): 1172–9. PMID 11071496.
- ↑ Poppert H, Morschhaeuser M, Feurer R, Bockelbrink A, Schwarze J, Esposito L; et al. (2008). "Lack of association between right-to-left shunt and cerebral ischemia after adjustment for gender and age". J Negat Results Biomed. 7: 7. doi:10.1186/1477-5751-7-7. PMC 2577085. PMID 18851751.
- ↑ Di Tullio MR, Sacco RL, Sciacca RR, Jin Z, Homma S (2007). "Patent foramen ovale and the risk of ischemic stroke in a multiethnic population". J Am Coll Cardiol. 49 (7): 797–802. doi:10.1016/j.jacc.2006.08.063. PMID 17306710.
- ↑ Meissner I, Khandheria BK, Heit JA, Petty GW, Sheps SG, Schwartz GL; et al. (2006). "Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study". J Am Coll Cardiol. 47 (2): 440–5. doi:10.1016/j.jacc.2005.10.044. PMID 16412874.