ArticleFrontiers in cardiovascular medicine2025
Predictive value of patent foramen ovale diameter for cryptogenic stroke and age-related differences.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management.MedComm · 2026Review
- Percutaneous closure of patent foramen ovale after cryptogenic stroke - a comparison between patients < 60 versus ≥ 60 years-of-age.Cardiovascular intervention and therapeutics · 2026Article
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Authors and funding
7 authors.
Funding
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Abstract
Introduction: Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS), whereas not all PFO carriers experience strokes. Current risk assessment tools like the Risk of Paradoxical Embolism (RoPE) scoring system and PFO-Associated Stroke Causal Likelihood (PASCAL) system have limitations, particularly in elderly populations. This study aims to explore risk factors for PFO-related CS and evaluate age-related differences between younger and elderly patients. Methods: This retrospective study included 344 patients with PFO, categorized into no stroke (NS), cryptogenic stroke (CS), and non-cryptogenic stroke (NCS) groups. Demographic, clinical, laboratory, and detailed PFO anatomical data were collected. Multivariate logistic regression and ROC analysis identified independent risk factors and optimal PFO diameter cut-off. Age subgroup analyses were performed. Results: 17.2% of PFO patients were found to have CS. The mean PFO diameter was significantly larger in CS (2.54 ± 0.79 mm) compared to NS (1.70 ± 0.73 mm) and NCS (1.98 ± 1.10 mm; Conclusion: CS was present in 17.2% of PFO patients. An enlarged diameter of PFO (optimal cut-off value: 1.75 mm in overall and younger; 1.95 mm in elderly) is a crucial anatomical risk factor. Elevated WBC, large RLS, previous stroke/TIA and cortical infarction are also correlated with CS. Age subgroup analysis revealed heterogeneity: PFO anatomy (diameter, RLS) is primary in younger patients, whereas in elderly patients (≥60 years), both PFO anatomy and systemic factors (smoking) should be considered.
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