title: Long-term risk of recurrent stroke in young cryptogenic stroke patients with and without patent foramen ovale.
abstract: BACKGROUND
  Among patients with a patent foramen ovale and cryptogenic ischemic stroke, the long-term prognosis is unclear.
  
  
  OBJECTIVE
  This study aims to estimate the recurrence rate in young cryptogenic stroke patients with and without patent foramen ovale.
  
  
  METHODS
  One hundred eighty-six cryptogenic stroke patients (aged 18-45 years) were prospectively followed for up to five-years. They were divided into two groups according to the echocardiographic presence of patent foramen ovale. All patients received aspirin (100 mg/day) for secondary prevention.
  
  
  RESULTS
  Mean age was 32·3 (standard deviation 7·9) years. During the mean follow-up of 66 months five patients with patent foramen ovale had recurrent strokes compared with 11 patients without patent foramen ovale. The average annual rate of recurrent cerebral ischemia was 1·1% and 1·6% for patients with and without patent foramen ovale, respectively. The recurrence rate did not increase with the presence of patent foramen ovale, atrial septal aneurysm or other variables. More than 60% of the reported cases achieved a good functional outcome.
  
  
  CONCLUSIONS
  Young patients with cryptogenic ischemic stroke with and without patent foramen ovale have a low recurrence rate in a long-term follow-up and most present a favorable outcome. Patent foramen ovale with or without atrial septal aneurysm did not increase the risk of recurrence.
authors: Stroke Clinic, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City (DF). antonio.arauz@prodigy.net.mx
authors: Antonio
authors: A
authors: Arauz
authors: Luis
authors: L
authors: Murillo
authors: Juan Manuel
authors: JM
authors: Márquez
authors: Arturo
authors: A
authors: Tamayo
authors: Carlos
authors: C
authors: Cantú
authors: Francisco-Javier
authors: FJ
authors: Roldan
authors: Jesús
authors: J
authors: Vargas-Barrón
authors: Fernando
authors: F
authors: Barinagarrementeria
mesh_terms: D000293:Adolescent; D000328:Adult; D001241:Aspirin / Q000008:administration & dosage; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D001241:Aspirin