Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults
ObjectiveTo explore the interaction effects between cardiac interatrial right-to-left shunt (RLS) and proatherosclerotic factors on the risk of brain ischaemia.DesignMulticentre Italian case–control study.SettingUniversity hospitals.Participants588 patients with cryptogenic stroke (CS) aged ≤45 year...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2012-03, Vol.98 (6), p.485-489 |
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| creator | Pezzini, Alessandro Grassi, Mario Lodigiani, Corrado Patella, Rosalba Gandolfo, Carlo Zini, Andrea Musolino, Rossella Calabrò, Rocco Salvatore Bovi, Paolo Adami, Alessandro DeLodovici, Maria Luisa Del Zotto, Elisabetta Rota, Lidia Luciana Rasura, Maurizia Del Sette, Massimo Spalloni, Alessandra Giossi, Alessia Volonghi, Irene Casoni, Federica Cerrato, Paolo Costa, Paolo Magoni, Mauro Toriello, Antonella Paciaroni, Maurizio Volta, Giorgio Dalla Iacoviello, Licia Padovani, Alessandro |
| description | ObjectiveTo explore the interaction effects between cardiac interatrial right-to-left shunt (RLS) and proatherosclerotic factors on the risk of brain ischaemia.DesignMulticentre Italian case–control study.SettingUniversity hospitals.Participants588 patients with cryptogenic stroke (CS) aged ≤45 years and 585 control subjects consecutively enrolled as part of the Italian Project on Stroke in Young Adults.MethodsInteraction effects between RLS and an individual proatherosclerotic score computed from the number of conventional vascular risk factors for the risk of CS were investigated. Data were examined by logistic regression models and expressed as interaction OR or interaction risk difference (RD).ResultsCS risk increased with increasing number of proatherosclerotic factors in subjects without RLS (OR 2.73; 95% CI 1.98 to 3.76; RD +0.246; 95% CI +0.17 to +0.32; for subjects with one or more factors), but was higher in subjects with RLS and no additional proatherosclerotic factors (OR 5.14; 95% CI 3.49 to 7.58; RD +0.388; 95% CI +0.31 to +0.47) compared with subjects without RLS and no risk factors. Negative interaction and antagonistic effects between RLS and proatherosclerotic factors were observed (interaction OR 0.52; 95% CI 0.31 to 0.91; interaction RD −0.17; 95% CI −0.29 to −0.05).ConclusionsThe influence of RLS on the risk of CS decreases with increasing number of atherosclerotic factors, and is highest when such factors are absent. Individual proatherosclerotic profiles may help to identify patients with CS whose patent foramen ovale is probably pathogenic. |
| doi_str_mv | 10.1136/heartjnl-2011-300970 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_953199722</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>953199722</sourcerecordid><originalsourceid>FETCH-LOGICAL-b458t-c78ea1c00f9cffe7251426680ddc7a8145141427691fa349cd6a8d70035180453</originalsourceid><addsrcrecordid>eNqNkc1u1DAUhS1ERUvhDRCyxIJVWtuxY4ddNQU6UtUiyv_G8jg3M8lk7MF2BH0SXhfPpO2CFRv_3POdq2sfhF5QckJpWZ2uwITUu6FghNKiJKSW5BE6orxSu9K3x_lcClFUpJSH6GmMPSGE16p6gg4ZY1IIJo7Qn7lLEIxNnXd4AekXgMPb4E1aQfDRDnlNncVtRnyI2LgGh265SkXyxQBtwnE1uoSzOzuyFNfYt9iG223yS3DZGlPwa3iz1-fJDJ1x-EPwPdi97WYv487h7350S3zWjEOKz9BBa4YIz-_2Y_T53dtPs4vi8vr9fHZ2WSy4UKmwUoGhlpC2tm0LkgnKWVUp0jRWGkV5vueKrGrampLXtqmMaiQhpaCKcFEeo9dT3_zmnyPEpDddtDAMxoEfo65FSetaMpbJV_-QvR-Dy8NpKhWRVFHGM8UnyubfiwFavQ3dxoRbTYne5abvc9O73PSUW7a9vGs-LjbQPJjug8pAMQFdTPD7QTdhrStZSqGvvsz0-dcfVx_FDdEq86cTv9j0_zfCX1kktdU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1780718124</pqid></control><display><type>article</type><title>Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Pezzini, Alessandro ; Grassi, Mario ; Lodigiani, Corrado ; Patella, Rosalba ; Gandolfo, Carlo ; Zini, Andrea ; Musolino, Rossella ; Calabrò, Rocco Salvatore ; Bovi, Paolo ; Adami, Alessandro ; DeLodovici, Maria Luisa ; Del Zotto, Elisabetta ; Rota, Lidia Luciana ; Rasura, Maurizia ; Del Sette, Massimo ; Spalloni, Alessandra ; Giossi, Alessia ; Volonghi, Irene ; Casoni, Federica ; Cerrato, Paolo ; Costa, Paolo ; Magoni, Mauro ; Toriello, Antonella ; Paciaroni, Maurizio ; Volta, Giorgio Dalla ; Iacoviello, Licia ; Padovani, Alessandro</creator><creatorcontrib>Pezzini, Alessandro ; Grassi, Mario ; Lodigiani, Corrado ; Patella, Rosalba ; Gandolfo, Carlo ; Zini, Andrea ; Musolino, Rossella ; Calabrò, Rocco Salvatore ; Bovi, Paolo ; Adami, Alessandro ; DeLodovici, Maria Luisa ; Del Zotto, Elisabetta ; Rota, Lidia Luciana ; Rasura, Maurizia ; Del Sette, Massimo ; Spalloni, Alessandra ; Giossi, Alessia ; Volonghi, Irene ; Casoni, Federica ; Cerrato, Paolo ; Costa, Paolo ; Magoni, Mauro ; Toriello, Antonella ; Paciaroni, Maurizio ; Volta, Giorgio Dalla ; Iacoviello, Licia ; Padovani, Alessandro ; Italian Project on Stroke in Young Adults Investigators</creatorcontrib><description>ObjectiveTo explore the interaction effects between cardiac interatrial right-to-left shunt (RLS) and proatherosclerotic factors on the risk of brain ischaemia.DesignMulticentre Italian case–control study.SettingUniversity hospitals.Participants588 patients with cryptogenic stroke (CS) aged ≤45 years and 585 control subjects consecutively enrolled as part of the Italian Project on Stroke in Young Adults.MethodsInteraction effects between RLS and an individual proatherosclerotic score computed from the number of conventional vascular risk factors for the risk of CS were investigated. Data were examined by logistic regression models and expressed as interaction OR or interaction risk difference (RD).ResultsCS risk increased with increasing number of proatherosclerotic factors in subjects without RLS (OR 2.73; 95% CI 1.98 to 3.76; RD +0.246; 95% CI +0.17 to +0.32; for subjects with one or more factors), but was higher in subjects with RLS and no additional proatherosclerotic factors (OR 5.14; 95% CI 3.49 to 7.58; RD +0.388; 95% CI +0.31 to +0.47) compared with subjects without RLS and no risk factors. Negative interaction and antagonistic effects between RLS and proatherosclerotic factors were observed (interaction OR 0.52; 95% CI 0.31 to 0.91; interaction RD −0.17; 95% CI −0.29 to −0.05).ConclusionsThe influence of RLS on the risk of CS decreases with increasing number of atherosclerotic factors, and is highest when such factors are absent. Individual proatherosclerotic profiles may help to identify patients with CS whose patent foramen ovale is probably pathogenic.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2011-300970</identifier><identifier>PMID: 22275525</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Adult ; Age ; Atherosclerosis - complications ; Atherosclerosis - etiology ; atrial fibrillation ; cardiac ; Case-Control Studies ; coagulation factors ; deep vein thrombosis ; Embolisms ; Female ; Flow velocity ; Foramen Ovale, Patent - complications ; gene association ; homocysteine ; Humans ; Italy ; Male ; platelet abnormalities ; Proteins ; Risk Factors ; risk factors in epidemiology ; Stroke ; Stroke - epidemiology ; Stroke - etiology ; stroke in young adults ; Studies ; thrombolysis ; transient ischaemic attack (TIA) ; Young adults</subject><ispartof>Heart (British Cardiac Society), 2012-03, Vol.98 (6), p.485-489</ispartof><rights>2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2012 (c) 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b458t-c78ea1c00f9cffe7251426680ddc7a8145141427691fa349cd6a8d70035180453</citedby><cites>FETCH-LOGICAL-b458t-c78ea1c00f9cffe7251426680ddc7a8145141427691fa349cd6a8d70035180453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/98/6/485.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/98/6/485.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,315,781,785,3197,23576,27929,27930,77605,77636</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22275525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pezzini, Alessandro</creatorcontrib><creatorcontrib>Grassi, Mario</creatorcontrib><creatorcontrib>Lodigiani, Corrado</creatorcontrib><creatorcontrib>Patella, Rosalba</creatorcontrib><creatorcontrib>Gandolfo, Carlo</creatorcontrib><creatorcontrib>Zini, Andrea</creatorcontrib><creatorcontrib>Musolino, Rossella</creatorcontrib><creatorcontrib>Calabrò, Rocco Salvatore</creatorcontrib><creatorcontrib>Bovi, Paolo</creatorcontrib><creatorcontrib>Adami, Alessandro</creatorcontrib><creatorcontrib>DeLodovici, Maria Luisa</creatorcontrib><creatorcontrib>Del Zotto, Elisabetta</creatorcontrib><creatorcontrib>Rota, Lidia Luciana</creatorcontrib><creatorcontrib>Rasura, Maurizia</creatorcontrib><creatorcontrib>Del Sette, Massimo</creatorcontrib><creatorcontrib>Spalloni, Alessandra</creatorcontrib><creatorcontrib>Giossi, Alessia</creatorcontrib><creatorcontrib>Volonghi, Irene</creatorcontrib><creatorcontrib>Casoni, Federica</creatorcontrib><creatorcontrib>Cerrato, Paolo</creatorcontrib><creatorcontrib>Costa, Paolo</creatorcontrib><creatorcontrib>Magoni, Mauro</creatorcontrib><creatorcontrib>Toriello, Antonella</creatorcontrib><creatorcontrib>Paciaroni, Maurizio</creatorcontrib><creatorcontrib>Volta, Giorgio Dalla</creatorcontrib><creatorcontrib>Iacoviello, Licia</creatorcontrib><creatorcontrib>Padovani, Alessandro</creatorcontrib><creatorcontrib>Italian Project on Stroke in Young Adults Investigators</creatorcontrib><title>Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>ObjectiveTo explore the interaction effects between cardiac interatrial right-to-left shunt (RLS) and proatherosclerotic factors on the risk of brain ischaemia.DesignMulticentre Italian case–control study.SettingUniversity hospitals.Participants588 patients with cryptogenic stroke (CS) aged ≤45 years and 585 control subjects consecutively enrolled as part of the Italian Project on Stroke in Young Adults.MethodsInteraction effects between RLS and an individual proatherosclerotic score computed from the number of conventional vascular risk factors for the risk of CS were investigated. Data were examined by logistic regression models and expressed as interaction OR or interaction risk difference (RD).ResultsCS risk increased with increasing number of proatherosclerotic factors in subjects without RLS (OR 2.73; 95% CI 1.98 to 3.76; RD +0.246; 95% CI +0.17 to +0.32; for subjects with one or more factors), but was higher in subjects with RLS and no additional proatherosclerotic factors (OR 5.14; 95% CI 3.49 to 7.58; RD +0.388; 95% CI +0.31 to +0.47) compared with subjects without RLS and no risk factors. Negative interaction and antagonistic effects between RLS and proatherosclerotic factors were observed (interaction OR 0.52; 95% CI 0.31 to 0.91; interaction RD −0.17; 95% CI −0.29 to −0.05).ConclusionsThe influence of RLS on the risk of CS decreases with increasing number of atherosclerotic factors, and is highest when such factors are absent. Individual proatherosclerotic profiles may help to identify patients with CS whose patent foramen ovale is probably pathogenic.</description><subject>Adult</subject><subject>Age</subject><subject>Atherosclerosis - complications</subject><subject>Atherosclerosis - etiology</subject><subject>atrial fibrillation</subject><subject>cardiac</subject><subject>Case-Control Studies</subject><subject>coagulation factors</subject><subject>deep vein thrombosis</subject><subject>Embolisms</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Foramen Ovale, Patent - complications</subject><subject>gene association</subject><subject>homocysteine</subject><subject>Humans</subject><subject>Italy</subject><subject>Male</subject><subject>platelet abnormalities</subject><subject>Proteins</subject><subject>Risk Factors</subject><subject>risk factors in epidemiology</subject><subject>Stroke</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>stroke in young adults</subject><subject>Studies</subject><subject>thrombolysis</subject><subject>transient ischaemic attack (TIA)</subject><subject>Young adults</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkc1u1DAUhS1ERUvhDRCyxIJVWtuxY4ddNQU6UtUiyv_G8jg3M8lk7MF2BH0SXhfPpO2CFRv_3POdq2sfhF5QckJpWZ2uwITUu6FghNKiJKSW5BE6orxSu9K3x_lcClFUpJSH6GmMPSGE16p6gg4ZY1IIJo7Qn7lLEIxNnXd4AekXgMPb4E1aQfDRDnlNncVtRnyI2LgGh265SkXyxQBtwnE1uoSzOzuyFNfYt9iG223yS3DZGlPwa3iz1-fJDJ1x-EPwPdi97WYv487h7350S3zWjEOKz9BBa4YIz-_2Y_T53dtPs4vi8vr9fHZ2WSy4UKmwUoGhlpC2tm0LkgnKWVUp0jRWGkV5vueKrGrampLXtqmMaiQhpaCKcFEeo9dT3_zmnyPEpDddtDAMxoEfo65FSetaMpbJV_-QvR-Dy8NpKhWRVFHGM8UnyubfiwFavQ3dxoRbTYne5abvc9O73PSUW7a9vGs-LjbQPJjug8pAMQFdTPD7QTdhrStZSqGvvsz0-dcfVx_FDdEq86cTv9j0_zfCX1kktdU</recordid><startdate>20120301</startdate><enddate>20120301</enddate><creator>Pezzini, Alessandro</creator><creator>Grassi, Mario</creator><creator>Lodigiani, Corrado</creator><creator>Patella, Rosalba</creator><creator>Gandolfo, Carlo</creator><creator>Zini, Andrea</creator><creator>Musolino, Rossella</creator><creator>Calabrò, Rocco Salvatore</creator><creator>Bovi, Paolo</creator><creator>Adami, Alessandro</creator><creator>DeLodovici, Maria Luisa</creator><creator>Del Zotto, Elisabetta</creator><creator>Rota, Lidia Luciana</creator><creator>Rasura, Maurizia</creator><creator>Del Sette, Massimo</creator><creator>Spalloni, Alessandra</creator><creator>Giossi, Alessia</creator><creator>Volonghi, Irene</creator><creator>Casoni, Federica</creator><creator>Cerrato, Paolo</creator><creator>Costa, Paolo</creator><creator>Magoni, Mauro</creator><creator>Toriello, Antonella</creator><creator>Paciaroni, Maurizio</creator><creator>Volta, Giorgio Dalla</creator><creator>Iacoviello, Licia</creator><creator>Padovani, Alessandro</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120301</creationdate><title>Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults</title><author>Pezzini, Alessandro ; Grassi, Mario ; Lodigiani, Corrado ; Patella, Rosalba ; Gandolfo, Carlo ; Zini, Andrea ; Musolino, Rossella ; Calabrò, Rocco Salvatore ; Bovi, Paolo ; Adami, Alessandro ; DeLodovici, Maria Luisa ; Del Zotto, Elisabetta ; Rota, Lidia Luciana ; Rasura, Maurizia ; Del Sette, Massimo ; Spalloni, Alessandra ; Giossi, Alessia ; Volonghi, Irene ; Casoni, Federica ; Cerrato, Paolo ; Costa, Paolo ; Magoni, Mauro ; Toriello, Antonella ; Paciaroni, Maurizio ; Volta, Giorgio Dalla ; Iacoviello, Licia ; Padovani, Alessandro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b458t-c78ea1c00f9cffe7251426680ddc7a8145141427691fa349cd6a8d70035180453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Age</topic><topic>Atherosclerosis - complications</topic><topic>Atherosclerosis - etiology</topic><topic>atrial fibrillation</topic><topic>cardiac</topic><topic>Case-Control Studies</topic><topic>coagulation factors</topic><topic>deep vein thrombosis</topic><topic>Embolisms</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Foramen Ovale, Patent - complications</topic><topic>gene association</topic><topic>homocysteine</topic><topic>Humans</topic><topic>Italy</topic><topic>Male</topic><topic>platelet abnormalities</topic><topic>Proteins</topic><topic>Risk Factors</topic><topic>risk factors in epidemiology</topic><topic>Stroke</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>stroke in young adults</topic><topic>Studies</topic><topic>thrombolysis</topic><topic>transient ischaemic attack (TIA)</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pezzini, Alessandro</creatorcontrib><creatorcontrib>Grassi, Mario</creatorcontrib><creatorcontrib>Lodigiani, Corrado</creatorcontrib><creatorcontrib>Patella, Rosalba</creatorcontrib><creatorcontrib>Gandolfo, Carlo</creatorcontrib><creatorcontrib>Zini, Andrea</creatorcontrib><creatorcontrib>Musolino, Rossella</creatorcontrib><creatorcontrib>Calabrò, Rocco Salvatore</creatorcontrib><creatorcontrib>Bovi, Paolo</creatorcontrib><creatorcontrib>Adami, Alessandro</creatorcontrib><creatorcontrib>DeLodovici, Maria Luisa</creatorcontrib><creatorcontrib>Del Zotto, Elisabetta</creatorcontrib><creatorcontrib>Rota, Lidia Luciana</creatorcontrib><creatorcontrib>Rasura, Maurizia</creatorcontrib><creatorcontrib>Del Sette, Massimo</creatorcontrib><creatorcontrib>Spalloni, Alessandra</creatorcontrib><creatorcontrib>Giossi, Alessia</creatorcontrib><creatorcontrib>Volonghi, Irene</creatorcontrib><creatorcontrib>Casoni, Federica</creatorcontrib><creatorcontrib>Cerrato, Paolo</creatorcontrib><creatorcontrib>Costa, Paolo</creatorcontrib><creatorcontrib>Magoni, Mauro</creatorcontrib><creatorcontrib>Toriello, Antonella</creatorcontrib><creatorcontrib>Paciaroni, Maurizio</creatorcontrib><creatorcontrib>Volta, Giorgio Dalla</creatorcontrib><creatorcontrib>Iacoviello, Licia</creatorcontrib><creatorcontrib>Padovani, Alessandro</creatorcontrib><creatorcontrib>Italian Project on Stroke in Young Adults Investigators</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pezzini, Alessandro</au><au>Grassi, Mario</au><au>Lodigiani, Corrado</au><au>Patella, Rosalba</au><au>Gandolfo, Carlo</au><au>Zini, Andrea</au><au>Musolino, Rossella</au><au>Calabrò, Rocco Salvatore</au><au>Bovi, Paolo</au><au>Adami, Alessandro</au><au>DeLodovici, Maria Luisa</au><au>Del Zotto, Elisabetta</au><au>Rota, Lidia Luciana</au><au>Rasura, Maurizia</au><au>Del Sette, Massimo</au><au>Spalloni, Alessandra</au><au>Giossi, Alessia</au><au>Volonghi, Irene</au><au>Casoni, Federica</au><au>Cerrato, Paolo</au><au>Costa, Paolo</au><au>Magoni, Mauro</au><au>Toriello, Antonella</au><au>Paciaroni, Maurizio</au><au>Volta, Giorgio Dalla</au><au>Iacoviello, Licia</au><au>Padovani, Alessandro</au><aucorp>Italian Project on Stroke in Young Adults Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2012-03-01</date><risdate>2012</risdate><volume>98</volume><issue>6</issue><spage>485</spage><epage>489</epage><pages>485-489</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>ObjectiveTo explore the interaction effects between cardiac interatrial right-to-left shunt (RLS) and proatherosclerotic factors on the risk of brain ischaemia.DesignMulticentre Italian case–control study.SettingUniversity hospitals.Participants588 patients with cryptogenic stroke (CS) aged ≤45 years and 585 control subjects consecutively enrolled as part of the Italian Project on Stroke in Young Adults.MethodsInteraction effects between RLS and an individual proatherosclerotic score computed from the number of conventional vascular risk factors for the risk of CS were investigated. Data were examined by logistic regression models and expressed as interaction OR or interaction risk difference (RD).ResultsCS risk increased with increasing number of proatherosclerotic factors in subjects without RLS (OR 2.73; 95% CI 1.98 to 3.76; RD +0.246; 95% CI +0.17 to +0.32; for subjects with one or more factors), but was higher in subjects with RLS and no additional proatherosclerotic factors (OR 5.14; 95% CI 3.49 to 7.58; RD +0.388; 95% CI +0.31 to +0.47) compared with subjects without RLS and no risk factors. Negative interaction and antagonistic effects between RLS and proatherosclerotic factors were observed (interaction OR 0.52; 95% CI 0.31 to 0.91; interaction RD −0.17; 95% CI −0.29 to −0.05).ConclusionsThe influence of RLS on the risk of CS decreases with increasing number of atherosclerotic factors, and is highest when such factors are absent. Individual proatherosclerotic profiles may help to identify patients with CS whose patent foramen ovale is probably pathogenic.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>22275525</pmid><doi>10.1136/heartjnl-2011-300970</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1355-6037 |
| ispartof | Heart (British Cardiac Society), 2012-03, Vol.98 (6), p.485-489 |
| issn | 1355-6037 1468-201X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_953199722 |
| source | MEDLINE; BMJ Journals - NESLi2; PubMed Central |
| subjects | Adult Age Atherosclerosis - complications Atherosclerosis - etiology atrial fibrillation cardiac Case-Control Studies coagulation factors deep vein thrombosis Embolisms Female Flow velocity Foramen Ovale, Patent - complications gene association homocysteine Humans Italy Male platelet abnormalities Proteins Risk Factors risk factors in epidemiology Stroke Stroke - epidemiology Stroke - etiology stroke in young adults Studies thrombolysis transient ischaemic attack (TIA) Young adults |
| title | Interaction between proatherosclerotic factors and right-to-left shunt on the risk of cryptogenic stroke: the Italian Project on Stroke in Young Adults |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-13T09%3A53%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Interaction%20between%20proatherosclerotic%20factors%20and%20right-to-left%20shunt%20on%20the%20risk%20of%20cryptogenic%20stroke:%20the%20Italian%20Project%20on%20Stroke%20in%20Young%20Adults&rft.jtitle=Heart%20(British%20Cardiac%20Society)&rft.au=Pezzini,%20Alessandro&rft.aucorp=Italian%20Project%20on%20Stroke%20in%20Young%20Adults%20Investigators&rft.date=2012-03-01&rft.volume=98&rft.issue=6&rft.spage=485&rft.epage=489&rft.pages=485-489&rft.issn=1355-6037&rft.eissn=1468-201X&rft_id=info:doi/10.1136/heartjnl-2011-300970&rft_dat=%3Cproquest_cross%3E953199722%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1780718124&rft_id=info:pmid/22275525&rfr_iscdi=true |