Prevalence of atrial septal abnormalities in older patients with cryptogenic ischemic stroke or transient ischemic attack

Objective: To evaluate the association of atrial septal abnormalities - patent foramen ovale (PFO), atrial septal aneurysm (ASA), or the combination of both (PFO + ASA) - with cryptogenic stroke or transient ischemic attack (TIA) in older patients. Methods: We examined the prevalences of PFO, ASA, and PFO + ASA in 132 consecutive patients aged 55 years or more who underwent transesophageal echocardiography (TEE) for evaluation of ischemic stroke or TIA. We compared patients with cryptogenic stroke/TIA and those with stroke/TIA of known cause. Results: PFO + ASA was more common in patients with cryptogenic stroke/TIA than in patients with stroke/TIA of known cause (12/62 or 19% vs. 2/70 or 3%; adjusted odds ratio, 7.4; 95% Cl, 1.4-38.2). Differences between groups for isolated PFO, and isolated ASA were not significant. The association of PFO + ASA with cryptogenic stroke/TIA was confirmed in the subgroup of patients aged 75 years or more (odds ratio. 15.0: 95%, Cl. 1.5-146.7). Conclusion: This study indicates a significant association of PFO + ASA with cryptogenic stroke or TIA in older patients. (C) 2008 Elsevier B.V. All rights reserved.