Prevalence of atrial septal abnormalities in older patients with cryptogenic ischemic stroke or transient ischemic attack.
OBJECTIVE
To evaluate the association of atrial septal abnormalities--patent foramen ovale (PFO), atrial septal aneurysm (ASA), or the combination of both (PFO+ASA)--with cryptogenic stroke or transient ischemic attack (TIA) in older patients.


METHODS
We examined the prevalences of PFO, ASA, and PFO+ASA in 132 consecutive patients aged 55 years or more who underwent transesophageal echocardiography (TEE) for evaluation of ischemic stroke or TIA. We compared patients with cryptogenic stroke/TIA and those with stroke/TIA of known cause.


RESULTS
PFO+ASA was more common in patients with cryptogenic stroke/TIA than in patients with stroke/TIA of known cause (12/62 or 19% vs. 2/70 or 3%; adjusted odds ratio, 7.4; 95% CI, 1.4-38.2). Differences between groups for isolated PFO, and isolated ASA were not significant. The association of PFO+ASA with cryptogenic stroke/TIA was confirmed in the subgroup of patients aged 75 years or more (odds ratio, 15.0; 95% CI, 1.5-146.7).


CONCLUSIONS
This study indicates a significant association of PFO+ASA with cryptogenic stroke or TIA in older patients.
Force
M
M
Department of Neurology, Hôpital Rangueil, University of Toulouse, Toulouse 31059, France.
Massabuau
P
P
Larrue
V
V
D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000150:complications / Q000453:epidemiology; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000453:epidemiology; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D014057:Tomography, X-Ray Computed