Abstract 18026: Is Patent Foramen Ovale (PFO) an Independent Risk Factor for Stroke in patients with Atrial Fibrillation
Background: Patent foreman ovale (PFO) is one of the well known risk factors for cryptogenic stroke. But no studies have evaluated whether PFO increased the risk of stroke in patients with atrial fibrillation irrespective of usual risk factors. Our hypothesis is PFO may be an independent risk factor for stroke in patients with atrial fibrillation and if proved, could be added to CHADS2 score.
Methods: Between Jan 2001 and Dec 2005, 286 consecutive adult patients were diagnosed with atrial fibrillation and PFO by transesophageal echocardiogram (TEE), while 1097 patients with atrial fibrillation patients didn’t have PFO by TEE. These patients were divided into ‘PFO group’ and ‘Control group’ respectively. Patients who had PFO closure during follow up were excluded.
Matching: Both the groups were matched (by 1:1 ratio propensity matching) for age, gender, diabetes, hypertension, dyslipidemia, chronic kidney disease, heart failure, aspirin, clopidogrel and warfarin. Two identical groups with 286 patients each were identified. Patients were followed up until Dec 2011. Baseline characteristics after propensity matching were shown in figure 1.
Results: Mean CHADS2 score was 1.54 ± 1.3 and 1.60 ± 1.4 in control and PFO groups respectively. 29 patients (10.7%) in the PFO group and 23 patients (8.4%) in the control group had stroke during follow up. Patients who had stroke prior to TEE date were not included in both groups. There was no significant difference in stroke rate between both groups in univariate analysis (p=0.35) and adjusted hazard ratio was 0.96 (95% CI, 0.55, 1.69, p = 0.90) in cox proportional analysis.
Conclusion: In patients with atrial fibrillation, there was no significant difference in stroke risk between patients with and without PFO. Presence of PFO may not be an independent predictor of stroke risk in patients with atrial fibrillation.
- © 2012 by American Heart Association, Inc.