■卵圆孔未闭(PFO)是一种先天性解剖变异,与年轻人的中风有关。与血管危险因素和动脉粥样硬化相反,PFO从出生就存在。然而,目前尚不清楚大部分人口出生时已经存在的解剖结构如何转化为PFO,导致少数人中风。最近的研究报道了年轻人中某些触发因素与缺血性卒中之间的显著关联。本研究旨在探讨PFO相关卒中的这些触发因素。
■ODYSSEY研究,一项2013年至2021年的多中心前瞻性队列研究纳入了18~49岁首次经历缺血事件的患者.参与者填写了一份关于暴露于潜在触发因素的问卷。使用病例交叉设计以95%置信区间(95%CI)评估相对风险(RR)。主要结果是PFO相关卒中的潜在触发因素的RR。
■总的来说,1043例患者完成了问卷调查,并有缺血性中风,其中124例患者患有PFO相关卒中(中位年龄42.1岁,45.2%男性)。对于PFO相关卒中患者,发热的RR为26.0(95%CI8.0-128.2),24.2(95%CI8.5-68.7)用于流感样疾病,剧烈运动为3.31(95%CI2.2-5.1)。
■总而言之,流感样疾病,发烧,剧烈运动可能会将无症状的PFO转化为导致中风的PFO。
■本研究中使用的原始数据和匿名数据可以根据要求提供给其他研究人员。书面建议可以提交给相应的作者,并将由ODYSSEY调查人员评估使用的适当性,在共享数据之前,将根据荷兰法规签订数据共享协议。
UNASSIGNED: Patent foramen ovale (PFO) is a congenital anatomical variant which is associated with strokes in young adults. Contrary to vascular risk factors and atherosclerosis, a PFO is present from birth. However, it is completely unknown how an anatomical structure that is already present at birth in a large proportion of the population can convert into a PFO that causes stroke in a few. Recent studies reported a significant association between certain trigger factors and ischemic stroke in young adults. This study aims to investigate these triggers in PFO-associated stroke.
UNASSIGNED: The ODYSSEY study, a multicenter prospective cohort study between 2013 and 2021, included patients aged 18-49 years experiencing their first-ever ischemic event. Participants completed a questionnaire about exposure to potential trigger factors. A
case-crossover design was used to assess the relative risks (RR) with 95% confidence intervals (95% CI). The primary outcome was the RR of potential trigger factors for PFO-associated stroke.
UNASSIGNED: Overall, 1043 patients completed the questionnaire and had an ischemic stroke, of which 124 patients had a PFO-associated stroke (median age 42.1 years, 45.2% men). For patients with PFO-associated stroke, the RR was 26.0 (95% CI 8.0-128.2) for fever, 24.2 (95% CI 8.5-68.7) for flu-like disease, and 3.31 (95% CI 2.2-5.1) for vigorous exercise.
UNASSIGNED: In conclusion, flu-like disease, fever, and vigorous exercise may convert an asymptomatic PFO into a stroke-causing PFO in young adults.
UNASSIGNED: The raw and anonymized data used in this study can be made available to other researchers on request. Written proposals can be addressed to the corresponding author and will be assessed by the ODYSSEY investigators for appropriateness of use, and a data sharing agreement in accordance with Dutch regulations will be put in place before data are shared.