London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 447 306 Etiology of stroke and risk factors Prevalence of patent foramen ovale in ischaemic stroke in Italy: the SISIFO Study A. Mattioni1, D. Consoli2, M. Paciaroni3, M. Aguggia4, M. Melis5, G. Malferrari6, S. Vidale7, P. Cerrato8, S. Sacco9, C. Gandolfo10, C. Serrati11, M. Del Sette12, A. Cavallini13, P. Postorino14, S. Ric-ci15 on behalf of SISIFO group UO Neurologia-Stroke Unit, ASL1 Umbria, Citta di Castello, ITALY1, UO Neurologia, Osped-ale G.Jazzolino, Vibo Valentia, ITALY2, Stroke Unit, University of Perugia, Perugia, ITALY3, Neu-rologia- Stroke Unit, Ospedale Cardinal Massaja, Asti, ITALY4, SC Neurologia-Stroke Unit, Azienda Ospedaliera G.Brotzu, Cagliari, ITALY5, Neurologia-Stroke Unit, Department of Neuromotor Phys-iology, Arcispedale Santa Maria Nuova, IRCCS Reggio Emilia, Reggio Emilia, ITALY6, Azienda Ospedaliera S.Anna, Como, ITALY7, AOU Molinette, Torino, ITALY8, Department of Neurology, University of L’aquila, L’Aquila, ITALY9, Stroke Unit, University of Genova, DINOGMI, Genova, ITALY10, AO San Martino, Genova, ITA-LY11, Neurology-Stroke Unit, S.Andrea Hospital, La Spezia, ITALY12, UC Malattie Cerebrovasco-lari- Stroke Unit, IRCCS INN C.Mondino, Pavia, ITALY13, UO Neurologia, Ospedale G.Jazzolino, Vibo Valentia, ITALY14, UO Neurologia-Stroke Unit, ASL1 Umbria, Citta di Castello, ITALY15 Background: Patent foramen ovale (PFO) is a congenital anatomical cardiac defect with a mean prevalence of 20% in general population. Several studies have suggested an association between cryptogenetic stroke and PFO, however the role of PFO as a risk factor for cerebral ischaemia is still debated. The gold standard to detect PFO is transesophageal echocardiography (TEE). Over the last decade TEE has been replaced by transcranial doppler (TCD) sonography associated to an echocar-diographic evaluation, both with infusion of agitated-saline as an echo-contrast. We aim to deter-mine the prevalence of PFO in an ischaemic stroke population and to identify a stroke recurrence profile risk in patients with PFO. Methods: This is a prospective multicentre study. All consecutive patients with acute ischaemic stroke are included. Demographics, vascular risk factors and National Institute of Health stroke scale score are registered. Echocardiographic and transcranial studies are performed in each patient to detect the presence of PFO. Prevalence of PFO will be calculated with 95% CIs. Univariate anal-ysis will be performed to detect the correlation of PFO with different registered factors and multi-variable analysis with PFO as independent variable. Results: So far we have included 926 patients. Recruitment will end in mid-February and analysis will be immediately prepared. Conclusions: This study should contribute to better identify the role of PFO in ischaemic stroke risk and recurrence-related events. Qualifying findings of the study are represented by the high number of enrolled patients, the prospective methodology of the study and the presence of secondary instru-mental endpoints. 307 Etiology of stroke and risk factors CHARACTERISTICS OF STROKE PATIENTS WITH HYPERHOMOCYSTEINEMIA L. Gungor1, K Balci2, A. Bedir3, H. Bagci4 Ondokuz Mayis University, Faculty of Medicine, Department of Neurology, Samsun, TUR-KEY1, Ondokuz Mayis University, Faculty of Medicine, Department of Neurology, Samsun, 2, On-dokuz Mayis University, Faculty of Medicine, Department of Neurology, Samsun, 3, Ondokuz May-is University, Faculty of Medicine, Department of Neurology, Samsun4 Background: High plasma homocysteine level is known to be a risk factor for ischemic stroke. It may cause early atherosclerosis by causing endothelial damage, lipid deposition and impairment of vascular dilatation by proinflammattory effect. In this study, we tried to determine the characteristics of the patients whose strokes were attributed to high plasma homocysteine levels. Methods: The data of 803 stroke patients reviewed retrospectively. Age, gender, stroke subtype, ad-ditional risk factors were compared with high and normal homocysteine levels. Results: Plasma homocysteine level was high in 79 patients (9,84%). The average plasma homocys-teine level was 27,88 (range 14,01-107,63) μmol/L. Mean age of patients with hyperhomocystein-emia was 42,61 years, and 59,44 in the remaining 722 stroke patients with normal plasma homocys-teine levels (p<0.05). Most of the patients with hyperhomocysteinemia were male (71,60% versus 55,68%, p<0.05). Lacunar infarctions (16,62% versus 12,60%), intracranial atherosclerosis (27,16% versus 5,12%), craniocervical arterial dissection (8,64% versus 4,57%) and cerebral venous throm-bosis (20,99% versus 12,05%) were more common in patients with high plasma homocysteine lev-els. Methylenetetrahydrofolate reductase gene mutation was detected in 32,91% of patients. 15,19% have had recurrent strokes, and 20,25% had other atherosclerotic disease. The most common accom-panying disease was coronary heart disease. Conclusion: High homocysteine may lead endothelial dysfunction, lipid deposition, inflammation and damage on the arterial wall. Especially young male patients are at risk. In concordance with the hypothesis of vessel wall damage, hyperhomocysteinemia may cause ischemic stroke by leading early intracranial atherosclerosis or cerebral small vessel disease, and dissection of the cranial ves-sels.
Karger_ESC London_2013
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