Trigger factors in patients with a patent foramen ovale-associated stroke: A case-crossover study.
Publication year
2024Author(s)
Source
International Journal of Stroke, 19, 7, (2024), pp. 809-816ISSN
Annotation
01 augustus 2024
Publication type
Article / Letter to editor
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Organization
Neurology
Cardiology
Journal title
International Journal of Stroke
Volume
vol. 19
Issue
iss. 7
Page start
p. 809
Page end
p. 816
Subject
Cardiology - Radboud University Medical Center; Neurology - Radboud University Medical Center - DCMNAbstract
BACKGROUND: Patent foramen ovale (PFO) is a congenital anatomical variant which is associated with strokes in young adults. Contrary to vascular risk factors and atherosclerosis, a PFO is present from birth. However, it is completely unknown how an anatomical structure that is already present at birth in a large proportion of the population can convert into a PFO that causes stroke in a few. Recent studies reported a significant association between certain trigger factors and ischemic stroke in young adults. This study aims to investigate these triggers in PFO-associated stroke. METHODS: The ODYSSEY study, a multicenter prospective cohort study between 2013 and 2021, included patients aged 18-49 years experiencing their first-ever ischemic event. Participants completed a questionnaire about exposure to potential trigger factors. A case-crossover design was used to assess the relative risks (RR) with 95% confidence intervals (95% CI). The primary outcome was the RR of potential trigger factors for PFO-associated stroke. RESULTS: Overall, 1043 patients completed the questionnaire and had an ischemic stroke, of which 124 patients had a PFO-associated stroke (median age 42.1 years, 45.2% men). For patients with PFO-associated stroke, the RR was 26.0 (95% CI 8.0-128.2) for fever, 24.2 (95% CI 8.5-68.7) for flu-like disease, and 3.31 (95% CI 2.2-5.1) for vigorous exercise. CONCLUSION: In conclusion, flu-like disease, fever, and vigorous exercise may convert an asymptomatic PFO into a stroke-causing PFO in young adults. DATA ACCESS STATEMENT: The raw and anonymized data used in this study can be made available to other researchers on request. Written proposals can be addressed to the corresponding author and will be assessed by the ODYSSEY investigators for appropriateness of use, and a data sharing agreement in accordance with Dutch regulations will be put in place before data are shared.
This item appears in the following Collection(s)
- Academic publications [245055]
- Electronic publications [132359]
- Faculty of Medical Sciences [93207]
- Open Access publications [105967]
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