Abstract Details

Title White Race Is Protective Against Patent Foramen Ovale in the Oldest Ischemic Stroke Patients

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) (-)

Poster/Presentation
Number 010

Objective

Background Patent foramen ovale (PFO) is associated with both cardioembolic and cryptogenic ischemic stroke. In the general population PFO prevalence is similar across racial groups and is thought to decrease with age. However, Reports of racial differences in cardioembolic and cryptogenic stroke prevalence have varied. Furthermore, racial differences of PFO prevalence with regards to age and ischemic stroke classification according to the Trial of Org. 10172 in Acute Stroke Treatment (TOAST) are still unknown.

Design/Methods Patients with ischemic stroke that presented to our center between 07/2008 and12/2010 were retrospectively identified by chart review. Patient demographics, TOAST classification, and PFO prevalence were collected. Patient age was broken down into quartiles. Transthoracic or transesophageal echocardiography using an agitated saline study was used to determine presence of PFO.

Results There were 240 black (58.3% male, age range 19-95, median 65, IQR 56,77) and 113 white (60.2% male, age range 22-97, median 66, IQR 56,76) patients identified. PFO prevalence did not significantly differ between races (25/240 B vs. 7/113 W, p=0.197). PFO prevalence did not decrease with age. In the highest age quartile (?78), White race appeared protective against having a PFO (OR 0.675, 95% CI 0.581-0.783, p=0.05). PFO prevalence in each TOAST sub group did not differ between races.

Conclusions In our sample of ischemic stroke patients, overall PFO prevalence was lower than previously reported, even amongst patients with "cryptogenic" stroke etiology. A PFO was just as likely in a patient with cryptogenic stroke as an alternate stroke etiology regardless of race. However, we found racial differences of PFO related to patient age; in the oldest patients with ischemic stroke, white patients had fewer PFOs. Further investigations are needed to elucidate the prevalence and relevance of PFO in differing stroke subtypes according to race.

Authors/Disclosures
Nicole Ulrich PRESENTER	No disclosure on file
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
Andre Kumar	No disclosure on file
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file
Stewart A. Factor, DO, FAAN (Emory University School of Medicine)	Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. The institution of Dr. Factor has received research support from Biohaven. The institution of Dr. Factor has received research support from Voyager. The institution of Dr. Factor has received research support from Neurocrine. The institution of Dr. Factor has received research support from Supernus. The institution of Dr. Factor has received research support from Prelinia. The institution of Dr. Factor has received research support from Medtronics. The institution of Dr. Factor has received research support from Boston Scientific. The institution of Dr. Factor has received research support from Sun Pharmaceuticals Advanced Research Company. The institution of Dr. Factor has received research support from Aspen. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care.

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