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Studies to date have shown an association between the presence of patent foramen ovale and cryptogenic stroke in patients younger than 55 years of age. This association has not been established in patients 55 years of age or older. METHODS We prospectively examined 503 consecutive patients who had had a stroke, and we compared the 227 patients with cryptogenic stroke and the 276 control patients with stroke of known cause. | Patent Foramen Ovale and Cryptogenic Stroke in Older Patients Patent Foramen Ovale and Cryptogenic Stroke in Older Patients Michael Handke M.D. Andreas Harloff M.D. Manfred Olschewski M.Sc. Andreas Hetzel M.D. and Annette Geibel M.D. abstract From the Departments of Cardiology and Angiology M.H. A.G. Neurology and Neurophysiology A. Harloff A. Hetzel and Medical Biometry and Statistics M.O. University Hospital Freiburg Freiburg Germany. Address reprint requests to Dr. Handke at the Department of Cardiology University Hospital Basel Petersgraben 4 4031 Basel Switzerland or at handkem@ uhbs.ch. Drs. Handke and Harloff contributed equally to this article. N Engl J Med 2007 357 2262-8. Copyright 2007 Massachusetts Medical Society. background Studies to date have shown an association between the presence of patent foramen ovale and cryptogenic stroke in patients younger than 55 years of age. This association has not been established in patients 55 years of age or older. methods We prospectively examined 503 consecutive patients who had had a stroke and we compared the 227 patients with cryptogenic stroke and the 276 control patients with stroke of known cause. We examined the prevalences of patent foramen ovale and of patent foramen ovale with concomitant atrial septal aneurysm in all patients using transesophageal echocardiography. We also compared data for the 131 younger patients 55 years of age and those for the 372 older patients 55 years of age . results The prevalence of patent foramen ovale was significantly greater among patients with cryptogenic stroke than among those with stroke of known cause for both younger patients 43.9 vs. 14.3 odds ratio 4.70 95 confidence interval CI 1.89 to 11.68 P 0.001 and older patients 28.3 vs. 11.9 odds ratio 2.92 95 CI 1.70 to 5.01 P 0.001 . Even stronger was the association between the presence of patent foramen ovale with concomitant atrial septal aneurysm and cryptogenic stroke as compared with stroke of known cause among .
