Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort
Objectives The purpose of this study was to evaluate the relationship between patent foramen ovale (PFO), ischemic stroke, and subclinical cerebrovascular disease in the general population. Background PFO is found more frequently in stroke patients than in stroke-free controls. However, the PFO-rela...
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| creator | Di Tullio, Marco R., MD Jin, Zhezhen, PhD Russo, Cesare, MD Elkind, Mitchell S.V., MD, MS Rundek, Tatjana, MD, PhD Yoshita, Mitsuhiro, MD, PhD DeCarli, Charles, MD Wright, Clinton B., MD, MS Homma, Shunichi, MD Sacco, Ralph L., MD, MS |
| description | Objectives The purpose of this study was to evaluate the relationship between patent foramen ovale (PFO), ischemic stroke, and subclinical cerebrovascular disease in the general population. Background PFO is found more frequently in stroke patients than in stroke-free controls. However, the PFO-related stroke risk in the general population is not well established, and the relationship between PFO and silent brain infarcts (SBI) is not known. Methods PFO presence was assessed by transthoracic echocardiography with saline contrast injection in 1,100 stroke-free individuals over age 39 of a community-based sample followed for a mean of 11 years. In addition, 360 participants underwent brain magnetic resonance imaging (MRI) for SBI detection. We evaluated the risk of stroke associated with PFO after adjusting for established stroke risk factors and examined the odds of having SBI among those with and without PFO. Results PFO was present in 164 participants (14.9%). Over a mean follow-up of 11.0 ± 4.5 years, 111 ischemic strokes occurred (10.1%), 15 (9.2%) in the PFO+ and 96 (10.3%) in the PFO− groups. The 12.5-year cumulative risk of stroke was 10.1% (standard error: 2.5%) in the PFO+ and 10.4% (standard error: 1.1%) in the PFO− group (p = 0.46). The adjusted hazard ratio for PFO and stroke was 1.10 (95% confidence interval [CI]: 0.64 to 1.91). In the MRI subcohort, PFO was not associated with SBI (adjusted odds ratio: 1.15, 95% CI: 0.50 to 2.62). Conclusions In this community-based cohort, PFO was not associated with an increased risk of clinical stroke or subclinical cerebrovascular disease. |
| doi_str_mv | 10.1016/j.jacc.2013.03.064 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3696432</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0735109713017385</els_id><sourcerecordid>3557210691</sourcerecordid><originalsourceid>FETCH-LOGICAL-c634t-87a76bc8b8c2f131dcb0e7438fee06c2458a58cca96f0531621bac2c57d77e393</originalsourceid><addsrcrecordid>eNp9kt9rFDEQxxdR7Fn9B3yQgAg-uGd-bJJdKAU9rRYKLZw-h-zsrJe7vc2Z7B70vzfLXVvtgzAwD_nMZL7znSx7zeicUaY-rudrCzDnlIk5TaGKJ9mMSVnmQlb6aTajWsic0UqfZC9iXFNKVcmq59kJF6ooaFnMss2NHbAfyIUPdos9ud7bDj-Q5VhD53oHtiMLDFgHv7cRxs4G8sVFtDFBtm_IZYQVbh2Q5RD8BonriSU3fpfIwfk-_5zIhiz8yofhZfastV3EV8d8mv28-Ppj8T2_uv52ufh0lYMSxZCX2mpVQ1mXwFsmWAM1RV2IskWkCnghSytLAFuplkrBFGe1BQ5SN1qjqMRpdn7ouxvrLTaQ9AXbmV1wWxtujbfO_PvSu5X55fdGqEoVgqcG748Ngv89YhzM1kXArrM9-jEaJjTXaevV9NfbR-jaj6FP8gxTheRasapIFD9QEHyMAdv7YRg1k5dmbSYvzeSloSnUVPTmbxn3JXfmJeDdEUjW2K4NtgcXHzgtaaG1TNzZgcO09L3DYCI47AEbFxAG03j3_znOH5XfncYGbzE-6DWRG2qW09VNR8cEZVqUUvwBVfnSLw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1645276194</pqid></control><display><type>article</type><title>Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Di Tullio, Marco R., MD ; Jin, Zhezhen, PhD ; Russo, Cesare, MD ; Elkind, Mitchell S.V., MD, MS ; Rundek, Tatjana, MD, PhD ; Yoshita, Mitsuhiro, MD, PhD ; DeCarli, Charles, MD ; Wright, Clinton B., MD, MS ; Homma, Shunichi, MD ; Sacco, Ralph L., MD, MS</creator><creatorcontrib>Di Tullio, Marco R., MD ; Jin, Zhezhen, PhD ; Russo, Cesare, MD ; Elkind, Mitchell S.V., MD, MS ; Rundek, Tatjana, MD, PhD ; Yoshita, Mitsuhiro, MD, PhD ; DeCarli, Charles, MD ; Wright, Clinton B., MD, MS ; Homma, Shunichi, MD ; Sacco, Ralph L., MD, MS</creatorcontrib><description>Objectives The purpose of this study was to evaluate the relationship between patent foramen ovale (PFO), ischemic stroke, and subclinical cerebrovascular disease in the general population. Background PFO is found more frequently in stroke patients than in stroke-free controls. However, the PFO-related stroke risk in the general population is not well established, and the relationship between PFO and silent brain infarcts (SBI) is not known. Methods PFO presence was assessed by transthoracic echocardiography with saline contrast injection in 1,100 stroke-free individuals over age 39 of a community-based sample followed for a mean of 11 years. In addition, 360 participants underwent brain magnetic resonance imaging (MRI) for SBI detection. We evaluated the risk of stroke associated with PFO after adjusting for established stroke risk factors and examined the odds of having SBI among those with and without PFO. Results PFO was present in 164 participants (14.9%). Over a mean follow-up of 11.0 ± 4.5 years, 111 ischemic strokes occurred (10.1%), 15 (9.2%) in the PFO+ and 96 (10.3%) in the PFO− groups. The 12.5-year cumulative risk of stroke was 10.1% (standard error: 2.5%) in the PFO+ and 10.4% (standard error: 1.1%) in the PFO− group (p = 0.46). The adjusted hazard ratio for PFO and stroke was 1.10 (95% confidence interval [CI]: 0.64 to 1.91). In the MRI subcohort, PFO was not associated with SBI (adjusted odds ratio: 1.15, 95% CI: 0.50 to 2.62). Conclusions In this community-based cohort, PFO was not associated with an increased risk of clinical stroke or subclinical cerebrovascular disease.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2013.03.064</identifier><identifier>PMID: 23644084</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age ; Aged ; atrium ; Biological and medical sciences ; Brain Ischemia - diagnosis ; Brain Ischemia - epidemiology ; Cardiac arrhythmia ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; cerebrovascular disorders ; Cerebrovascular Disorders - diagnosis ; Cerebrovascular Disorders - epidemiology ; Cohort Studies ; Confidence intervals ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Diabetes ; Disease prevention ; Drug therapy ; echocardiography ; Electrocardiography ; epidemiology ; Ethnicity ; Female ; Follow-Up Studies ; Foramen Ovale, Patent - diagnosis ; Foramen Ovale, Patent - epidemiology ; Heart ; Humans ; Hypertension ; Internal Medicine ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Neurology ; NMR ; Nuclear magnetic resonance ; Pneumology ; Population ; Population Surveillance - methods ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Respiratory system : syndromes and miscellaneous diseases ; Risk Factors ; Stroke ; Stroke - diagnosis ; Stroke - epidemiology ; Studies ; Substance abuse treatment ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Journal of the American College of Cardiology, 2013-07, Vol.62 (1), p.35-41</ispartof><rights>American College of Cardiology Foundation</rights><rights>2013 American College of Cardiology Foundation</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 2, 2013</rights><rights>2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c634t-87a76bc8b8c2f131dcb0e7438fee06c2458a58cca96f0531621bac2c57d77e393</citedby><cites>FETCH-LOGICAL-c634t-87a76bc8b8c2f131dcb0e7438fee06c2458a58cca96f0531621bac2c57d77e393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109713017385$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27504775$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23644084$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Tullio, Marco R., MD</creatorcontrib><creatorcontrib>Jin, Zhezhen, PhD</creatorcontrib><creatorcontrib>Russo, Cesare, MD</creatorcontrib><creatorcontrib>Elkind, Mitchell S.V., MD, MS</creatorcontrib><creatorcontrib>Rundek, Tatjana, MD, PhD</creatorcontrib><creatorcontrib>Yoshita, Mitsuhiro, MD, PhD</creatorcontrib><creatorcontrib>DeCarli, Charles, MD</creatorcontrib><creatorcontrib>Wright, Clinton B., MD, MS</creatorcontrib><creatorcontrib>Homma, Shunichi, MD</creatorcontrib><creatorcontrib>Sacco, Ralph L., MD, MS</creatorcontrib><title>Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives The purpose of this study was to evaluate the relationship between patent foramen ovale (PFO), ischemic stroke, and subclinical cerebrovascular disease in the general population. Background PFO is found more frequently in stroke patients than in stroke-free controls. However, the PFO-related stroke risk in the general population is not well established, and the relationship between PFO and silent brain infarcts (SBI) is not known. Methods PFO presence was assessed by transthoracic echocardiography with saline contrast injection in 1,100 stroke-free individuals over age 39 of a community-based sample followed for a mean of 11 years. In addition, 360 participants underwent brain magnetic resonance imaging (MRI) for SBI detection. We evaluated the risk of stroke associated with PFO after adjusting for established stroke risk factors and examined the odds of having SBI among those with and without PFO. Results PFO was present in 164 participants (14.9%). Over a mean follow-up of 11.0 ± 4.5 years, 111 ischemic strokes occurred (10.1%), 15 (9.2%) in the PFO+ and 96 (10.3%) in the PFO− groups. The 12.5-year cumulative risk of stroke was 10.1% (standard error: 2.5%) in the PFO+ and 10.4% (standard error: 1.1%) in the PFO− group (p = 0.46). The adjusted hazard ratio for PFO and stroke was 1.10 (95% confidence interval [CI]: 0.64 to 1.91). In the MRI subcohort, PFO was not associated with SBI (adjusted odds ratio: 1.15, 95% CI: 0.50 to 2.62). Conclusions In this community-based cohort, PFO was not associated with an increased risk of clinical stroke or subclinical cerebrovascular disease.</description><subject>Age</subject><subject>Aged</subject><subject>atrium</subject><subject>Biological and medical sciences</subject><subject>Brain Ischemia - diagnosis</subject><subject>Brain Ischemia - epidemiology</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>cerebrovascular disorders</subject><subject>Cerebrovascular Disorders - diagnosis</subject><subject>Cerebrovascular Disorders - epidemiology</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Diabetes</subject><subject>Disease prevention</subject><subject>Drug therapy</subject><subject>echocardiography</subject><subject>Electrocardiography</subject><subject>epidemiology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Foramen Ovale, Patent - diagnosis</subject><subject>Foramen Ovale, Patent - epidemiology</subject><subject>Heart</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Pneumology</subject><subject>Population</subject><subject>Population Surveillance - methods</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Risk Factors</subject><subject>Stroke</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Studies</subject><subject>Substance abuse treatment</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kt9rFDEQxxdR7Fn9B3yQgAg-uGd-bJJdKAU9rRYKLZw-h-zsrJe7vc2Z7B70vzfLXVvtgzAwD_nMZL7znSx7zeicUaY-rudrCzDnlIk5TaGKJ9mMSVnmQlb6aTajWsic0UqfZC9iXFNKVcmq59kJF6ooaFnMss2NHbAfyIUPdos9ud7bDj-Q5VhD53oHtiMLDFgHv7cRxs4G8sVFtDFBtm_IZYQVbh2Q5RD8BonriSU3fpfIwfk-_5zIhiz8yofhZfastV3EV8d8mv28-Ppj8T2_uv52ufh0lYMSxZCX2mpVQ1mXwFsmWAM1RV2IskWkCnghSytLAFuplkrBFGe1BQ5SN1qjqMRpdn7ouxvrLTaQ9AXbmV1wWxtujbfO_PvSu5X55fdGqEoVgqcG748Ngv89YhzM1kXArrM9-jEaJjTXaevV9NfbR-jaj6FP8gxTheRasapIFD9QEHyMAdv7YRg1k5dmbSYvzeSloSnUVPTmbxn3JXfmJeDdEUjW2K4NtgcXHzgtaaG1TNzZgcO09L3DYCI47AEbFxAG03j3_znOH5XfncYGbzE-6DWRG2qW09VNR8cEZVqUUvwBVfnSLw</recordid><startdate>20130702</startdate><enddate>20130702</enddate><creator>Di Tullio, Marco R., MD</creator><creator>Jin, Zhezhen, PhD</creator><creator>Russo, Cesare, MD</creator><creator>Elkind, Mitchell S.V., MD, MS</creator><creator>Rundek, Tatjana, MD, PhD</creator><creator>Yoshita, Mitsuhiro, MD, PhD</creator><creator>DeCarli, Charles, MD</creator><creator>Wright, Clinton B., MD, MS</creator><creator>Homma, Shunichi, MD</creator><creator>Sacco, Ralph L., MD, MS</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</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>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130702</creationdate><title>Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort</title><author>Di Tullio, Marco R., MD ; Jin, Zhezhen, PhD ; Russo, Cesare, MD ; Elkind, Mitchell S.V., MD, MS ; Rundek, Tatjana, MD, PhD ; Yoshita, Mitsuhiro, MD, PhD ; DeCarli, Charles, MD ; Wright, Clinton B., MD, MS ; Homma, Shunichi, MD ; Sacco, Ralph L., MD, MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c634t-87a76bc8b8c2f131dcb0e7438fee06c2458a58cca96f0531621bac2c57d77e393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Aged</topic><topic>atrium</topic><topic>Biological and medical sciences</topic><topic>Brain Ischemia - diagnosis</topic><topic>Brain Ischemia - epidemiology</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>cerebrovascular disorders</topic><topic>Cerebrovascular Disorders - diagnosis</topic><topic>Cerebrovascular Disorders - epidemiology</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Diabetes</topic><topic>Disease prevention</topic><topic>Drug therapy</topic><topic>echocardiography</topic><topic>Electrocardiography</topic><topic>epidemiology</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Foramen Ovale, Patent - diagnosis</topic><topic>Foramen Ovale, Patent - epidemiology</topic><topic>Heart</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Pneumology</topic><topic>Population</topic><topic>Population Surveillance - methods</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Risk Factors</topic><topic>Stroke</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Studies</topic><topic>Substance abuse treatment</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Tullio, Marco R., MD</creatorcontrib><creatorcontrib>Jin, Zhezhen, PhD</creatorcontrib><creatorcontrib>Russo, Cesare, MD</creatorcontrib><creatorcontrib>Elkind, Mitchell S.V., MD, MS</creatorcontrib><creatorcontrib>Rundek, Tatjana, MD, PhD</creatorcontrib><creatorcontrib>Yoshita, Mitsuhiro, MD, PhD</creatorcontrib><creatorcontrib>DeCarli, Charles, MD</creatorcontrib><creatorcontrib>Wright, Clinton B., MD, MS</creatorcontrib><creatorcontrib>Homma, Shunichi, MD</creatorcontrib><creatorcontrib>Sacco, Ralph L., MD, MS</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Tullio, Marco R., MD</au><au>Jin, Zhezhen, PhD</au><au>Russo, Cesare, MD</au><au>Elkind, Mitchell S.V., MD, MS</au><au>Rundek, Tatjana, MD, PhD</au><au>Yoshita, Mitsuhiro, MD, PhD</au><au>DeCarli, Charles, MD</au><au>Wright, Clinton B., MD, MS</au><au>Homma, Shunichi, MD</au><au>Sacco, Ralph L., MD, MS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2013-07-02</date><risdate>2013</risdate><volume>62</volume><issue>1</issue><spage>35</spage><epage>41</epage><pages>35-41</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives The purpose of this study was to evaluate the relationship between patent foramen ovale (PFO), ischemic stroke, and subclinical cerebrovascular disease in the general population. Background PFO is found more frequently in stroke patients than in stroke-free controls. However, the PFO-related stroke risk in the general population is not well established, and the relationship between PFO and silent brain infarcts (SBI) is not known. Methods PFO presence was assessed by transthoracic echocardiography with saline contrast injection in 1,100 stroke-free individuals over age 39 of a community-based sample followed for a mean of 11 years. In addition, 360 participants underwent brain magnetic resonance imaging (MRI) for SBI detection. We evaluated the risk of stroke associated with PFO after adjusting for established stroke risk factors and examined the odds of having SBI among those with and without PFO. Results PFO was present in 164 participants (14.9%). Over a mean follow-up of 11.0 ± 4.5 years, 111 ischemic strokes occurred (10.1%), 15 (9.2%) in the PFO+ and 96 (10.3%) in the PFO− groups. The 12.5-year cumulative risk of stroke was 10.1% (standard error: 2.5%) in the PFO+ and 10.4% (standard error: 1.1%) in the PFO− group (p = 0.46). The adjusted hazard ratio for PFO and stroke was 1.10 (95% confidence interval [CI]: 0.64 to 1.91). In the MRI subcohort, PFO was not associated with SBI (adjusted odds ratio: 1.15, 95% CI: 0.50 to 2.62). Conclusions In this community-based cohort, PFO was not associated with an increased risk of clinical stroke or subclinical cerebrovascular disease.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>23644084</pmid><doi>10.1016/j.jacc.2013.03.064</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged atrium Biological and medical sciences Brain Ischemia - diagnosis Brain Ischemia - epidemiology Cardiac arrhythmia Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease cerebrovascular disorders Cerebrovascular Disorders - diagnosis Cerebrovascular Disorders - epidemiology Cohort Studies Confidence intervals Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Diabetes Disease prevention Drug therapy echocardiography Electrocardiography epidemiology Ethnicity Female Follow-Up Studies Foramen Ovale, Patent - diagnosis Foramen Ovale, Patent - epidemiology Heart Humans Hypertension Internal Medicine Male Medical imaging Medical sciences Middle Aged Neurology NMR Nuclear magnetic resonance Pneumology Population Population Surveillance - methods Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Respiratory system : syndromes and miscellaneous diseases Risk Factors Stroke Stroke - diagnosis Stroke - epidemiology Studies Substance abuse treatment Vascular diseases and vascular malformations of the nervous system |
| title | Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort |
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