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Patent Foramen Ovale Linked with Cryptogenic Stroke

Paradoxical embolism is likely cause of stroke in older and younger patients

WEDNESDAY, Nov. 28 (HealthDay News) -- Patent foramen ovale is independently associated with cryptogenic stroke in both older and younger patients, according to an article published in the Nov. 29 issue of the New England Journal of Medicine.

Michael Handke, M.D., of University Hospital Freiburg in Freiburg, Germany, and colleagues performed transesophageal echocardiography on 227 patients with cryptogenic stroke and 276 control patients with stroke of known cause in order to determine the association between patent foramen ovale and cryptogenic stroke in both younger (under 55 years) and older patients.

Individuals with cryptogenic stroke were significantly more likely to have a patent foramen ovale than those with stroke of known cause, both for younger patients (43.9 percent versus 14.3 percent) and older patients (28.3 percent versus 11.9 percent). An even stronger association was noted between the presence of patent foramen ovale with concomitant atrial septal aneurysm and cryptogenic stroke. Controlling for age, plaque thickness, hypertension and coronary artery disease revealed that patent foramen ovale was independently associated with cryptogenic stroke in younger (odds ratio 3.70) and older patients (odds ratio 3.00).

"There is an association between the presence of patent foramen ovale and cryptogenic stroke in both older patients and younger patients. These data suggest that paradoxical embolism is a cause of stroke in both age groups," the authors conclude.

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