{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:35:19Z","timestamp":1790220919730,"version":"4.1.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,2,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patent foramen ovale (PFO) is causally associated with stroke in some patients younger than 60\u2009years, especially when it is large or associated with an atrial septal aneurysm (ASA). After 60\u2009years of age, this association is less well understood. We assessed the relationships between detailed atrial septal anatomy and the cryptogenic nature of stroke in this population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We reviewed all patients aged 60 to 80\u2009years admitted to our stroke center for ischemic stroke who underwent contrast echocardiography between 2016 and 2021. The atherosclerosis, small\u2010vessel disease, cardiac pathology, other causes, and dissection\u00a0(ASCOD) classification was used to reevaluate the etiological workup. Associations between cryptogenic stroke and (1) PFO presence or (2) categories of PFO anatomy (nonlarge PFO without ASA, nonlarge PFO with ASA, large PFO without ASA, and large PFO with ASA) were assessed using logistic regression. Among 533 patients (median National Institutes of Health Stroke Scale score=1), PFO was present in 152 (prevalence, 28.5% [95% CI, 24.9\u201332.5]). Compared with noncryptogenic stroke, cryptogenic stroke (n=218) was associated with PFO presence (44.5% versus 17.5%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Among patients with a PFO, septal anatomy categories were associated with cryptogenic stroke (\n              <jats:italic>P<\/jats:italic>\n              =0.02), with a strong association for patients with both large PFO and ASA (38.1% versus 14.5%,\n              <jats:italic>P<\/jats:italic>\n              =0.002).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">PFO presence remains strongly associated with cryptogenic stroke between 60 and 80\u2009years of age. Large PFO, ASA, and their association were strongly associated with cryptogenic stroke in this age group. Our results support performing contrast echocardiography even after 60\u2009years of age, although the optimal secondary prevention therapy in this population remains to be determined in randomized trials.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031684","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T11:29:01Z","timestamp":1707910141000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Does Atrial Septal Anatomy Still Matter in the Etiological Evaluation of Ischemic Stroke Beyond the Age of 60?"],"prefix":"10.1161","volume":"13","author":[{"given":"Antoine","family":"Dusonchet","sequence":"first","affiliation":[{"name":"Department of Neurology, GHU Paris Psychiatrie et Neurosciences H\u00f4pital Sainte\u2010Anne, Universit\u00e9 Paris Cit\u00e9, INSERM U1266, and FHU Neurovasc Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1308-8860","authenticated-orcid":false,"given":"Olivier","family":"Varenne","sequence":"additional","affiliation":[{"name":"Department of Cardiology H\u00f4pital Cochin, AP\u2010HP, Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1362-5880","authenticated-orcid":false,"given":"Tania","family":"Puscas","sequence":"additional","affiliation":[{"name":"Department of Cardiology H\u00f4pital Europ\u00e9en Georges Pompidou, AP\u2010HP, Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malika","family":"Saadi","sequence":"additional","affiliation":[{"name":"Department of Cardiology H\u00f4pital Cochin, AP\u2010HP, Universit\u00e9 Paris Cit\u00e9 Paris 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Paris Cit\u00e9, INSERM U1266, and FHU Neurovasc Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5059-4095","authenticated-orcid":false,"given":"Guillaume","family":"Turc","sequence":"additional","affiliation":[{"name":"Department of Neurology, GHU Paris Psychiatrie et Neurosciences H\u00f4pital Sainte\u2010Anne, Universit\u00e9 Paris Cit\u00e9, INSERM U1266, and FHU Neurovasc Paris 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