{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:08:27Z","timestamp":1782389307708,"version":"3.54.5"},"reference-count":21,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: The Risk of Paradoxical Embolism (RoPE) score was developed to identify stroke-related patent foramen ovale (PFO) in patients with cryptogenic stroke. Methods: We conducted a retrospective analysis of the 2016 to 2020 National Inpatient Sample to determine the performance of the modified RoPE score in identifying the presence of a PFO in patients with acute ischemic stroke (AIS). Results: A total of 3,338,805 hospital admissions for AIS were analysed and 3.0% had PFO. Patients with PFO were younger compared to those without a PFO (median 63 years vs. 71 years, p &lt; 0.001) and fewer were female (46.1% vs. 49.7%, p &lt; 0.001). The patients with PFO had greater mean modified RoPE scores (4.0 vs. 3.3, p &lt; 0.001). The area under the curve for the RoPE score in predicting PFOs was 0.625 (95%CI 0.620\u20130.629). The best diagnostic power of the RoPE score was achieved with a cut-off point of \u22654 where the sensitivity was 55% and the specificity was 64.2%. A cut-off point of \u22655 increased the specificity (83.1%) at the expense of sensitivity (35.8%). The strongest predictor of PFOs was deep vein thrombosis (OR 3.97, 95%CI 3.76\u20134.20). Conclusions: The modified RoPE score had modest predictive value in identifying patients with PFO among patients admitted with AIS.<\/jats:p>","DOI":"10.3390\/jcdd11070213","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T11:46:05Z","timestamp":1720179965000},"page":"213","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Modified Risk of Paradoxical Embolism Score Is Associated with Patent Foramen Ovale in Patients with Ischemic Stroke: A Nationwide US Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7047-1586","authenticated-orcid":false,"given":"Chun Shing","family":"Kwok","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0795-3985","authenticated-orcid":false,"given":"Zaheer","family":"Alisiddiq","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9217-0191","authenticated-orcid":false,"given":"Maximilian","family":"Will","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, University Hospital St. P\u00f6lten, Karl Landsteiner University of Health Sciences, 3100 Krems, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, University Hospital St. P\u00f6lten, Karl Landsteiner University of Health Sciences, 3100 Krems, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee","family":"Khoo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Large","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L69 3BX, UK"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan I.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO 65211, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4878-8146","authenticated-orcid":false,"given":"Josip Andelo","family":"Borovac","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15086","DOI":"10.1038\/nrdp.2015.86","article-title":"Patent foramen ovale","volume":"2","author":"Homma","year":"2016","journal-title":"Nat. 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