Sex differences in cryptogenic stroke with patent foramen ovale
| Autor: | Stephan Windecker, Sebastian Wiedmer, Heinrich Mattle, Bernhard Meier, Tobias Haefeli, Marcel Arnold, Krassen Nedeltchev, Markus Schwerzmann |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Cardiac Catheterization Adolescent medicine.medical_treatment Foramen secundum Foramen Ovale Patent Persistent fetal circulation Age Distribution Risk Factors Internal medicine Prevalence Medicine Humans cardiovascular diseases Sex Distribution Stroke Cardiac catheterization Aged Aged 80 and over Sex Characteristics business.industry Vascular disease Middle Aged medicine.disease Ischemic Attack Transient Patent foramen ovale Etiology Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal Sex characteristics |
| Zdroj: | American heart journal. 156(3) |
| ISSN: | 1097-6744 |
| Popis: | Background Sex differences in patients with patent foramen ovale (PFO) and cryptogenic stroke have not been systematically analyzed. We aimed to determine sex influences on demographics, vascular risk factors, clinical manifestations, stroke location, and clinical outcome. Methods One thousand two hundred eighty-eight consecutive patients with ischemic stroke or transient ischemic attack (TIA) were admitted to a single stroke center. All patients underwent a complete stroke workup including clinical examination, standard blood tests, cerebral and vascular imaging, transesophageal echocardiography, and 24-hour electrocardiography. In 500 patients, no definite etiology could be established (cryptogenic stroke/TIA). Of them, 167 patients (107 men and 60 women, mean age 52 ± 13 years) had an PFO. Results The prevalence of PFO in patients with cryptogenic stroke or TIA was higher in men than in women (38% vs 28%, P = .014). Stroke severity and the prevalence of risk factors did not differ between the 2 sexes. There was an independent association between male sex and stroke location in the posterior cerebral circulation (OR 3.0, 95% CI 1.4-6.5, P = .006). Men and women did not differ in respect to PFO grade, prevalence of right-to-left shunt at rest, or coexistence of atrial septal aneurysm. Clinical outcome at 3 months was similar in both sexes. Conclusion Patent foramen ovale was more prevalent in men than in women with cryptogenic stroke. There were no sex influences on age, risk factors, echocardiographic characteristics of PFO, or clinical outcome. Male sex was independently associated with stroke in the posterior cerebral circulation. |
| Databáze: | OpenAIRE |
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