Carotid Atherosclerosis and Patent Foramen Ovale in Embolic Stroke of Undetermined Source.

Details

Serval ID
serval:BIB_A806C12C805F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Carotid Atherosclerosis and Patent Foramen Ovale in Embolic Stroke of Undetermined Source.
Journal
Journal of stroke and cerebrovascular diseases
Author(s)
Ntaios G., Sagris D., Strambo D., Perlepe K., Sirimarco G., Georgiopoulos G., Nannoni S., Korompoki E., Manios E., Makaritsis K., Vemmos K., Michel P.
ISSN
1532-8511 (Electronic)
ISSN-L
1052-3057
Publication state
Published
Issued date
01/2021
Peer-reviewed
Oui
Volume
30
Number
1
Pages
105409
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Carotid atherosclerosis and likely pathogenic patent foramen ovale (PFO) are two potential embolic sources in patients with embolic stroke of undetermined source (ESUS). The relationship between these two mechanisms among ESUS patients remains unclear.
To investigate the relation between carotid atherosclerosis and likely pathogenic PFO in patients with ESUS. We hypothesized that ipsilateral carotid atherosclerotic plaques are less prevalent in ESUS with likely pathogenic PFO compared to patients with likely incidental PFO or without PFO.
The presence of PFO was assessed with transthoracic echocardiography with microbubble test and, when deemed necessary, through trans-oesophageal echocardiography. The presence of PFO was considered as likely incidental if the RoPE (Risk of Paradoxical Embolism) score was 0-6 and likely pathogenic if 7-10.
Among 374 ESUS patients (median age: 61years, 40.4% women), there were 63 (49.6%) with likely incidental PFO, 64 (50.4%) with likely pathogenic PFO and 165 (44.1%) with ipsilateral carotid atherosclerosis. The prevalence of ipsilateral carotid atherosclerosis was lower in patients with likely pathogenic PFO (7.8%) compared to patients with likely incidental PFO (46.0%) or patients without PFO (53.0%) (p<0.001). After adjustment for multiple confounders, the prevalence of ipsilateral carotid atherosclerosis remained lower in patients with likely pathogenic PFO compared to patients with likely incidental PFO or without PFO (adjusted OR=0.32, 95%CI:0.104-0.994, p=0.049).
The presence of carotid atherosclerosis is inversely related to the presence of likely pathogenic PFO in patients with ESUS.
Keywords
Adult, Aged, Carotid Artery Diseases/diagnostic imaging, Carotid Artery Diseases/epidemiology, Embolic Stroke/diagnostic imaging, Embolic Stroke/epidemiology, Female, Foramen Ovale, Patent/diagnostic imaging, Foramen Ovale, Patent/epidemiology, Humans, Incidence, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Assessment, Risk Factors, Carotid atherosclerosis, Embolic stroke of undetermined source, Patent foramen ovale, RoPE score
Pubmed
Web of science
Open Access
Yes
Create date
09/11/2020 10:08
Last modification date
14/01/2021 7:23
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