• Pol. Arch. Med. Wewn. · Sep 2022

    Recurrent cerebrovascular events in patients with history of cryptogenic stroke or transient ischemic attack and patent foramen ovale in long term follow-up.

    • Przemysław Węglarz, Mateusz Polak, Karolina Bula, Ewa Konarska-Kuszewska, Maciej Wybraniec, Tomasz Bochenek, and Katarzyna Mizia-Stec.
    • First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
    • Pol. Arch. Med. Wewn. 2022 Sep 26; 132 (9).

    IntroductionCryptogenic stroke may be associated with a patent foramen ovale (PFO). Both cardiovascular risk factors and transcatheter closure of PFO may have an impact on the risk of recurrent cerebrovascular events.ObjectivesThe aim of the study was to assess the occurrence and risk factors of recurrent cerebrovascular events (rCVE) in patients with a history of cryptogenic stroke or transient ischemic attack (TIA) and PFO.Patients And MethodsOverall, 392 patients (median [interquartile range, IQR] age 39.5 [30-49] years, 64.3% women, 35.7% men) with a history of cryptogenic stroke / TIA and confirmed PFO underwent a long‑term follow‑up with a median (IQR) of 51.5 (35-65) months. The primary end point was defined as rCVE including stroke and TIA.ResultsDuring the follow‑up, 17 patients with a history of cryptogenic stroke / TIA and confirmed PFO (4.3%, 11 women, 6 men) developed rCVE. In a multivariable analysis, the Risk of Paradoxical Embolism (RoPE) score was associated with a lower risk of rCVE (odds ratio [OR], 0.61 per 1 point; 95% CI, 0.45-0.84; P = 0.002). The transcatheter closure of PFO did not have a significant impact on rCVE in the study population (P = 0.19).ConclusionsThe occurrence of rCVE in the patients with cryptogenic stroke / TIA and PFO reached 4.3% regardless of a high percentage of patients who underwent the PFO closure. RoPE score was associated with a lower risk of rCVE in the study population.

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