Right to Left Shunt and Cryptogenic Stroke in Patients Over 60 Years Old.

Autor: Zikova SD; Department of Neurology, City General Hospital '8th September', Skopje, RN Macedonia., Arsovska A; University Clinic of Neurology, Faculty of Medicine, University 'Ss Cyril and Methodius', Skopje, RN Macedonia., Samoilovska DV; Faculty of Health Sciences, SEEU, Tetovo, RN Macedonia., Jovevska S; Faculty of Medical Science, Goce Delčev University, Štip, RN Macedonia., Gongo FA; Healthcare Center, Skopje, RN Macedonia.
Jazyk: angličtina
Zdroj: Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) [Pril (Makedon Akad Nauk Umet Odd Med Nauki)] 2024 Dec 12; Vol. 45 (3), pp. 37-46. Date of Electronic Publication: 2024 Dec 12 (Print Publication: 2024).
DOI: 10.2478/prilozi-2024-0021
Abstrakt: Objective: To determine the possible role of patent foramen ovale (PFO) as indicated by a right to left shunt and cryptogenic stroke in patients aged ≥ 60 years and to compare the prevalence of patent foramen ovale with stroke of known cause.
Methods: We prospectively examined the prevalence of PFO using contrast enhanced colour Transcranial Doppler ultrasonography (bubble-cTCD) in 86 consecutive patients aged ≥60 years with transient ischaemic attack (TIA) or stroke and 86 consecutive patients aged <60 years with TIA/stroke as a control group. Patients with cryptogenic stroke were compared to stroke patients with known cause.
Results: A significantly higher prevalence of PFO in patients with cryptogenic compared to patients with stroke of known cause was registered in the patients aged < 60 years (56.6% vs.18.8%) and in patients aged ≥ 60 years (37.14% vs.11.76%), respectively. Multivariate analysis adjusted for age, hypertension and coronary disease showed that the existence of R-to-L shunt (RLS) was independently associated with cryptogenic stroke in both, in the younger group (odds ratio 4.012; 95% CI1.323 to 12.171, p =0.0143.70) and in the older group (odds ratio 3.197; 95% CI 1.140 to 10.877, p=0.037).
Conclusion: Our findings suggest that PFO is strongly associated with cryptogenic stroke in patients aged ≥ 60 years. Bubble - cTCD was feasible and suitable as a first-line method for the detection of PFO in older patients.
(© 2024 Sanja Djambazovska Zikova et al., published by Sciendo.)
Databáze: MEDLINE
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