Title:Modified Risk of Paradoxical Embolism More Effectively Evaluates the
Risk of Stroke Associated with Patent Foramen Ovale
Volume: 20
Issue: 3
Author(s): Yun Wang*, Tun Zhao, Yajun Ma and Wenli Hu
Affiliation:
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
Keywords:
Patent foramen ovale, ischemic stroke, risk factor, Risk of Paradoxical Embolism, global burden, PFO-associated stroke.
Abstract:
Background: Through an analysis of the risk factors associated with patent foramen
ovale (PFO)-related stroke (PS), we aimed to modify the Risk of Paradoxical Embolism (RoPE) to
assess the risk of PS.
Methods: A retrospective collection of ischemic stroke (IS) patients with PFO admitted to the Department
of Neurology at Beijing Chaoyang Hospital was conducted. The patients were classified
into PS and non-PS groups. PS risk factors and RoPE scoring were analyzed based on clinical data,
laboratory indicators, and imaging data. Independent risk factors were incorporated into the RoPE
scoring system for enhancement.
Results: Significant differences were observed between the two groups regarding total cholesterol,
low-density lipoprotein-cholesterol (LDL-C), and uric acid levels. The transverse diameter of the
left atrium was significantly larger in the non-PS group compared to the PS group. Multivariate
logistic regression revealed that higher LDL-C levels and a smaller transverse diameter of the left
atrium increased the risk of PS. The modified RoPE score was derived by assigning 1 point each
for high LDL-C levels and the absence of transverse diameter enlargement in the left atrium. The
area under the curve (AUC) of the receiver operating characteristic (ROC) curves for the classical
and modified RoPE score distinguishing PS were 0.661 and 0.798, respectively.
Conclusion: LDL-C levels and transverse diameter of the left atrium were identified as independent
risk factors for PS. The modified RoPE scoring system exhibited superior performance in assessing
the risk of PS compared to the original RoPE score.
