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Comparison of stroke recurrence between antiplatelet and closure therapy in cryptogenic stroke patients with patent foramen ovale and its influencing factors

  • Chuanjing Zhang
    Affiliations
    Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), No.568, Zhongxing North Road, Shaoxing, Zhejiang Province 312000 China

    Zhejiang University School of Medicine, Hangzhou, China
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  • Liangrong Zheng
    Affiliations
    Department of Cardiology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
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  • Yanxing Zhang
    Affiliations
    Department of Neurology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
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  • Hangyuan Guo
    Affiliations
    Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), No.568, Zhongxing North Road, Shaoxing, Zhejiang Province 312000 China
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  • Jufang Chi
    Correspondence
    Corresponding author at:
    Affiliations
    Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), No.568, Zhongxing North Road, Shaoxing, Zhejiang Province 312000 China
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Published:April 16, 2020DOI:https://doi.org/10.1016/j.ejim.2020.04.007
      Stroke is the second highest disease causing burden on the global economy and one of the leading causes of non-traumatic disability [
      • Murray C.J.
      • Lopez A.D.
      Measuring the global burden of disease[J].
      ]. As many as 30–40% of ischemic stroke cases have no identified medical cause, known as cryptogenic stroke (CS) [
      • Hart R.G.
      • Diener H.C.
      • Coutts S.B.
      • et al.
      Embolic strokes of undetermined source: the case for a new clinical construct[J].
      ]. Within the last century, the incidence of patent foramen ovale (PFO) in patients with CS is as high as 50–60%, which is significantly higher than 20–30% in the normal population [
      • Hara H.
      • Virmani R.
      • Ladich E.
      • et al.
      Patent foramen ovale: current pathology, pathophysiology, and clinical status[J].
      ]. In the past two decades, to explore the effective treatment of patients with CS and PFO, several related experiments have been conducted in the academic community. After contradictory views and negative results, it was finally confirmed that closure therapy can significantly reduce the risk of stroke recurrence [
      • Mas J.L.
      • Derumeaux G.
      • Guillon B.
      • et al.
      Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke[J].
      ,
      • Saver J.L.
      • Carroll J.D.
      • Thaler D.E.
      • et al.
      Long-Term outcomes of patent foramen ovale closure or medical therapy after stroke[j].
      ,
      • Søndergaard L.
      • Kasner S.E.
      • Rhodes J.F.
      • et al.
      Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke[j].
      ]. However, literature on the Asian population with a high incidence of stroke, particularly on biomarkers for risk factors for stroke recurrence, is currently lacking.

      Keywords

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