Patent foramen ovale ups ischemic stroke in those with PE

(HealthDay)—For patients with symptomatic pulmonary embolism (PE), the frequency of recent ischemic stroke is higher in those with patent foramen ovale (PFO), according to a study published online May 7 in the Annals of Internal Medicine.

Emmanuelle Le Moigne, M.D., Ph.D., from Brest University Hospital in France, and colleagues conducted a prospective study at four French hospital centers involving 361 consecutive patients with symptomatic acute PE. Within seven days after enrollment, patients underwent systematic contrast transthoracic echocardiography (TTE) and cerebral magnetic resonance imaging (MRI).

The researchers found that contrast TTE was conclusive in 324 patients and showed PFO in 13 percent. Fifty-one percent of patients had associated deep venous thrombosis, 91 percent had cardiovascular risk factors, and 10 percent presented with arrhythmia. In 315 patients, cerebral MRI was conclusive. The frequency of recent ischemic stroke was higher in the PFO versus the non-PFO group (21.4 percent of 41 patients versus 5.5 percent of 273; difference in proportions, 15.9 percentage points).

"This finding supports the hypothesis that paradoxical embolism is an important mechanism of ischemic stroke in patients with concomitant PFO and PE," the authors write. "Nevertheless, whether patients with PE should be screened for PFO in daily practice remains to be determined."

Several authors disclosed financial ties to the pharmaceutical industry.

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