Risk Factors for Stroke Associated with Patent Foramen Ovale

YAN Zhenfu; WANG Dongwei; WANG Ping; LIU Cuncun

doi:10.3969/j.issn.1004-437X.2026.15.003

Abstract：Objective To investigate and identify the risk factors for stroke associated with patent foramen ovale(PFO).Methods This study retrospectively selected 858 PFO patients admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to August 2024,and divided them into a stroke group of 193 cases and a non stroke group of 665 cases based on whether they experienced stroke.Collect two sets of clinical data and use logistic regression analysis to screen for independent risk factors associated with PFO related stroke.Results In the stroke group,the proportions of age,body mass index(BMI),systolic and diastolic blood pressure,homocysteine(Hcy)levels,male sex,hypertension,diabetes,previous stroke history,and smoking were significantly higher compared to the non-stroke group(P＜0.05).Conversely,the proportion of migraine was lower in the stroke group than in the non-stroke group(P＜0.05).Additionally,the stroke group exhibited greater PFO channel length and width(P＜0.05),as well as higher proportions of atrial septal protrusion,increased secondary septal thickness,excessively long inferior vena cava valve,Chiari network,resting right-to-left shunt,and large right-to-left shunts compared to the non-stroke group(P＜0.05).Multivariate logistic regression analysis revealed that in PFO patients,elevated systolic blood pressure,longer PFO channel length,and the presence of resting right-to-left shunt were independent risk factors for stroke occurrence.Conclusion This study identified systolic blood pressure,PFO channel length,and resting right to left shunt as independent risk factors for stroke in PFO patients through multiple logistic regression analysis.These results provide important evidence for clinical assessment of stroke risk in PFO patients,helping to identify high-risk patients early and take targeted preventive measures.