London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 491 386 Heart and brain Cryptogenic stroke in young patients – a retrospective critical survey on the role of PFO and hypertension based on the Sheffield Heart-Brain MDT patients S. Murali-Krishnan1, C. Blank2, K. Harkness3, R. Lindert4, L. O’Toole5, G. Venables6, J. West7, M. Randall8 University of Sheffield, Sheffield, UNITED KINGDOM1, Sheffield Teaching Hospitals, Shef-field, UNITED KINGDOM2, Sheffield Teaching Hospitals, Sheffield, UNITED KINGDOM3, Shef-field Teaching Hospitals, Sheffield, UNITED KINGDOM4, Sheffield Teaching Hospitals, Sheffield, UNITED KINGDOM5, Sheffield Teaching Hospitals, Sheffield, UNITED KINGDOM6, Sheffield Teaching Hospitals, Sheffield, UNITED KINGDOM7, Sheffield Teaching Hospitals, Sheffield, UNITED KINGDOM8 Introduction Patent foramen ovale (PFO) is apparently more frequent in subjects who have suffered a stroke (~50%) compared to the general population (~25%). This study challenges the hypothesis that the apparent higher rate of PFO in stroke subjects may be equalized by other risk factor such as e.g. hy-pertension Methods A retrospective analysis of subjects aging 18-60 diagnosed with indeterminate cause of stroke or transient ischemic attack utilizing the Sheffield Heart-Brain MDT risk factor and transcranial Dop-pler (TCD) (with and without Valsalva maneuver) data. Study subjects were categorized according to the presence of shunts and hypertension. The data was cross-tabulated and analysed by Pearson Chi-Square test. Results Preliminary results from 222 patients are listed in Table 1. The Pearson Chi-Square test gave a result of 14.680, which gives a P-value of 0.000. The odds of having a shunt detected for patients with hy-pertension was 29.2% (95%CI 15.3-55.8) of that for patients without hypertension. Conclusion The preliminary data suggest that the rate of PFOs in stroke patients with hypertension is signifi-cantly lower than in patients without hypertension. Hence, the data proposes that clinical manage-ment of young patients with cryptogenic stroke should also focus on the presence of additional risk factors such as e.g. hypertension in addition to detecting PFOs. 387 Heart and brain Female Gender Predicts Development of Atrial Fibrillation After a Stroke or Transient Isch-aemic Attack J.H.J. See1, J. Chow2 Changi General Hospital, Singapore, SINGAPORE1, Changi General Hospital, Singapore, SIN-GAPORE2 Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Common risk factors for AF in-clude valvular heart disease, congestive cardiac failure and advancing age. AF is prevalent in isch-aemic strokes and is a risk factor for recurrence. This study aims to evaluate the predictors for the development of AF in patients after they present with an ischaemic stroke or transient ischaemic at-tack. Methods This is a single center retrospective cohort study of 287 consecutive patients with ischaemic strokes or transient ischaemic attacks admitted to an acute stroke unit between January and June 2009. 203 patients had echocardiograms performed as part of their workup and had follow up data up till 3 years post event. Of these 203 patients, 162 of them did not have presence of AF before or during admission and were analyzed using SPSS version 16. Results Mean age of the study population was 62.1 years. Majority of patients are male (66.0%). 6 (3.7%) patients had newly diagnosed AF within 3 years from initial event. Fisher’s exact test revealed pre-dictors for AF to include more advanced age (>65 years), female gender, absence of diabetes, larg-er left atrial height (>5.2cm) and diameter (>4.4cm). History of hypertension, congestive cardiac failure, previous strokes or transient ischaemic attacks were not found to be significant. Logistic regression performed found only female gender (p=0.024) and left atrial height (p=0.031) to be in-dependent predictors of AF onset. Conclusion Female gender is an independent predictor for the development of AF in patients who have pre-sented with a stroke or transient ischaemic attack. Unsurprisingly, size of the left atrium is also associated with AF development. In female patients with enlarged left atriums who present with an ischaemic event, further investigations such as Holter monitoring could be undertaken to seek a diagnosis of AF so that appropriate anticoagulant therapy can be instituted to prevent recurrent strokes.
Karger_ESC London_2013
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