Role of interatrial block in modulating cryptogenic stroke risk in patients with patent foramen ovale: a retrospective study

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY BMC Neurology Pub Date : 2024-09-14 DOI:10.1186/s12883-024-03829-3
Ye Du, Yanxing Zhang, Yangbo Xing, Xiatian Liu, Huayong Jin, Yuxin Zhang, Chengyi Li, Buyun Xu
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Abstract

The patent foramen ovale (PFO) and interatrial block (IAB) are associated with cryptogenic stroke (CS). However, the role of the interaction between PFO and IAB in CS remains unclear. This case–control study enrolled 256 patients with CS and 156 individuals without a history of stroke or transient ischemic attack. IAB was defined as P wave duration > 120 ms. PFO was evaluated by contrast transesophageal echocardiography, and classified as no-PFO, low-risk PFO and high-risk PFO. Multiplicative and additive interaction analysis were used to assess the interaction between PFO and IAB in CS. Multiplicative interaction analysis unveiled a significant interaction between IAB and low-risk PFO in CS (OR for interaction = 3.653, 95% CI, 1.115–12.506; P = 0.037). Additive interaction analysis indicated that 68.4% (95% CI, 0.333–1.050; P < 0.001) of the increased risk of CS related to low-risk PFO was attributed to the interaction with IAB. The results were robust in multivariate analysis. However, but no significant multiplicative or additive interaction was observed between IAB and high-risk PFO. When stratified by IAB, high-risk PFO was associated with CS in both patients with IAB (OR, 4.186; 95% CI, 1.617–10.839; P = 0.003) and without IAB (OR, 3.476; 95% CI, 1.790–6.750; P < 0.001). However, low-risk PFO was only associated with CS in patients with IAB (OR, 2.684; 95% CI, 1.007–7.149; P = 0.048) but not in those without IAB (OR, 0.753; 95% CI, 0.343–1.651; P = 0.479). The interaction between IAB and PFO might play an important role in CS, particularly in cases with low-risk PFO.
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房室间阻滞在调节卵圆孔未闭患者隐源性中风风险中的作用:一项回顾性研究
卵圆孔未闭(PFO)和房室间阻滞(IAB)与隐源性中风(CS)有关。然而,PFO 和 IAB 之间的相互作用在 CS 中的作用仍不清楚。这项病例对照研究共纳入了 256 名 CS 患者和 156 名无中风或短暂性脑缺血发作病史的患者。IAB 的定义是 P 波持续时间大于 120 毫秒。通过对比经食道超声心动图评估 PFO,并将其分为无 PFO、低风险 PFO 和高风险 PFO。乘法和加法交互分析用于评估 CS 中 PFO 和 IAB 之间的交互作用。乘法交互作用分析揭示了 CS 中 IAB 与低风险 PFO 之间的显著交互作用(交互作用 OR = 3.653,95% CI,1.115-12.506;P = 0.037)。相加交互作用分析表明,68.4%(95% CI,0.333-1.050;P < 0.001)与低危 PFO 相关的 CS 风险增加归因于与 IAB 的交互作用。这一结果在多变量分析中也是稳健的。但是,在 IAB 和高危 PFO 之间没有观察到明显的乘法或加法交互作用。当按 IAB 分层时,在有 IAB 的患者(OR,4.186;95% CI,1.617-10.839;P = 0.003)和无 IAB 的患者(OR,3.476;95% CI,1.790-6.750;P < 0.001)中,高危 PFO 与 CS 相关。然而,低风险 PFO 仅与 IAB 患者的 CS 相关(OR,2.684;95% CI,1.007-7.149;P = 0.048),而与无 IAB 患者的 CS 无关(OR,0.753;95% CI,0.343-1.651;P = 0.479)。IAB 和 PFO 之间的相互作用可能在 CS 中起重要作用,尤其是在低风险 PFO 病例中。
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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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