%0 Journal Article
%T The Modified Risk of Paradoxical Embolism Score Is Associated with Patent Foramen Ovale in Patients with Ischemic Stroke: A Nationwide US Analysis.
%A Kwok CS
%A Alisiddiq Z
%A Will M
%A Schwarz K
%A Khoo C
%A Large A
%A Butler R
%A Lip GYH
%A Qureshi AI
%A Borovac JA
%J J Cardiovasc Dev Dis
%V 11
%N 7
%D 2024 Jul 5
%M 39057633
%F 4.415
%R 10.3390/jcdd11070213
%X <B>BACKGROUND: </B>The Risk of Paradoxical Embolism (RoPE) score was developed to identify stroke-related patent foramen ovale (PFO) in patients with cryptogenic stroke.<BR><B>METHODS: </B>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).<BR><B>RESULTS: </B>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 < 0.001) and fewer were female (46.1% vs. 49.7%, p < 0.001). The patients with PFO had greater mean modified RoPE scores (4.0 vs. 3.3, p < 0.001). The area under the curve for the RoPE score in predicting PFOs was 0.625 (95%CI 0.620-0.629). The best diagnostic power of the RoPE score was achieved with a cut-off point of ≥4 where the sensitivity was 55% and the specificity was 64.2%. A cut-off point of ≥5 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 3.76-4.20).<BR><B>CONCLUSIONS: </B>The modified RoPE score had modest predictive value in identifying patients with PFO among patients admitted with AIS.