Increased frequency of cardioembolism and patent foramen ovale in patients with stroke and a positive travel history suggesting economy class stroke syndrome

被引:17
作者
Heckmann, J. G.
Stadter, M.
Reulbach, U.
Duetsch, M.
Nixdorff, U.
Ringwald, J.
机构
[1] Univ Erlangen Nurnberg, Dept Neurol, D-8520 Erlangen, Germany
[2] Univ Erlangen Nurnberg, Inst Biostat, D-8520 Erlangen, Germany
[3] Univ Erlangen Nurnberg, Dept Cardiol, D-8520 Erlangen, Germany
[4] Univ Erlangen Nurnberg, Dept Transfus Med & Hemostasiol, D-8520 Erlangen, Germany
关键词
D O I
10.1136/hrt.2005.077131
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To investigate the frequency of acute stroke in patients with a recent travel history and to analyse risk factors, stroke patterns and presence of a patent foramen ovale (PFO) in this patient group. Design: One-year prospective observational study. Setting: Single-centre study. Methods: Enrolling all patients presenting with a first cerebral ischaemia and complementing the usual history with a standardised travel history. Results: Of 338 patients with acute stroke, 42 had a positive travel history (PTH) (12.4%). Patients with a PTH were significantly younger (56.6 (SD 13) years) than patients (66.9 (13.2) years, p = 0.0001) with a negative travel history (NTH). Frequency of PFO in the PTH group (13; 44.8%) was significantly higher than in the NTH group (7; 10.8%) (p = 0.0001), even after patients were dichotomised into two age groups (younger and older than median of all patients: 31% v 6.1%, p = 0.007 and 13.8% v 4.6%, p = 0.022, respectively). PTH patients had fewer stroke risk factors (2.2 (1.4) v 3.3 (1.6), p = 0.0001) and a different risk profile with a lower frequency of diabetes (11.9% v 31.4%, p = 0.009), hypertension (52.4% v 78.7%, p = 0.0001), atrial fibrillation (7.1% v 22%, p = 0.025) and others (16.7% v 38.9%, p = 0.005). In contrast, PTH patients had significantly more cardioembolic (35.7% v 19.3%, p = 0.023) and cryptogenic strokes (50% v 19.9%, p = 0.0001) and more often ischaemia in the territory of the posterior cerebral artery (29.6% v 6.3%, p = 0.0001). Conclusions: The finding that more PTH patients had a PFO and a cardioembolic stroke pattern but that fewer had other typical stroke risk factors led to the hypothesis that PFO is a risk factor for economy class stroke syndrome.
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页码:1265 / 1268
页数:4
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