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논문 기본 정보

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학술저널
저자정보
Pil Hyung Lee (Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea) Jung-Sun Kim (Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea) Jae-Kwan Song (Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea) Sun U. Kwon (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea) Bum Joon Kim (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea) Ji Sung Lee (Clinical Research Center, Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea) Byung Joo Sun (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea) Jong Shin Woo (Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea) Soe Hee Ann (Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea) Jung-Won Suh (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea) Jun Yup Kim (Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea) Kyusup Lee (Department of Cardiology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea) Sang Yeub Lee (Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea) Ran Heo (Division of Cardiology, Hanyang University Medical Center, College of Medicine, Hanyang University, Seoul, Korea) Soo Jeong (Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea) Jeong Yoon Jang (Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea) Jang-Whan Bae (Regional Cardiovascular Disease Center, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea) Young Dae Kim (Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Department of Neurology, Yonsei University College of Medicine, Seoul, Korea) Sung Hyuk Heo (Department of Neurology, Kyung Hee University Hospital, Seoul, Korea) Jong S. Kim (Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중영문학회지 제26권 제2호
발행연도
2024.5
수록면
242 - 251 (10page)

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Background and Purpose In young patients (aged 18–60 years) with patent foramen ovale (PFO)- associated stroke, percutaneous closure has been found to be useful for preventing recurrent ischemic stroke or transient ischemic attack (TIA). However, it remains unknown whether PFO closure is also beneficial in older patients. Methods Patients aged ≥60 years who had a cryptogenic stroke and PFO from ten hospitals in South Korea were included. The effect of PFO closure plus medical therapy over medical therapy alone was assessed by a propensity-score matching method in the overall cohort and in those with a high-risk PFO, characterized by the presence of an atrial septal aneurysm or a large shunt. Results Out of the 437 patients (mean age, 68.1), 303 (69%) had a high-risk PFO and 161 (37%) patients underwent PFO closure. Over a median follow-up of 3.9 years, recurrent ischemic stroke or TIA developed in 64 (14.6%) patients. In the propensity score-matched cohort of the overall patients (130 pairs), PFO closure was associated with a significantly lower risk of a composite of ischemic stroke or TIA (hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.24–0.84; P=0.012), but not for ischemic stroke. In a subgroup analysis of confined to the high-risk PFO patients (116 pairs), PFO closure was associated with significantly lower risks of both the composite of ischemic stroke or TIA (HR: 0.40; 95% CI: 0.21–0.77; P=0.006) and ischemic stroke (HR: 0.47; 95% CI: 0.23–0.95; P=0.035). Conclusion Elderly patients with cryptogenic stroke and PFO have a high recurrence rate of ischemic stroke or TIA, which may be significantly reduced by device closure.
#Cryptogenic stroke #Patent foramen ovale #Device closure #Stroke prevention #Elderly patients

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