title: Predictors of recurrent stroke after percutaneous closure of patent foramen ovale.
abstract: OBJECTIVE
  Closure of patent foramen ovale following presumed paradoxical embolic stroke remains controversial. The answer to the question as to whether cardiovascular risk factors (CVRF) impact on the recurrence of stroke in patients who have undergone PFO closure remains elusive so far. We aimed to investigate the potential impact of CVRF on the long-term rate of stroke/TIA recurrence in patients treated with an occluder following presumed paradoxical embolic stroke.
  
  
  RESULTS
  443 patients (mean age: 50.0±12.6 yrs, female: 206 [46.5%]) undergoing percutaneous PFO closure after presumed paradoxical embolic stroke were followed for a median time of 43.0 [interquartile range: 20.0-86.0] months. During the follow-up period a total of 22 (5.0%) strokes/TIAs and 17 (3.8%) deaths were observed. Cox regression analysis identified hypertension, age and the Essen stroke risk score as predictors of recurrent stroke/TIA.
  
  
  CONCLUSIONS
  This study shows that, in patients with a prior presumed paradoxical embolic stroke, the risk for recurrent stroke/TIA after PFO closure is firmly linked to the presence of CVRF.
authors.affiliation: University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Rudolph
authors.forename: Jahan
authors.initials: J
authors.lastname: Augustin
authors.forename: Thomas
authors.initials: T
authors.lastname: Hofmann
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Ralf
authors.initials: R
authors.lastname: Köster
authors.forename: Stephan
authors.initials: S
authors.lastname: Baldus
authors.forename: Olaf
authors.initials: O
authors.lastname: Franzen
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome