FIGHTING THE FEAR OF THE UNKNOWN

UNDERSTANDING THE COMMON CHALLENGES IN TREATING CRYPTOGENIC STROKE*

*Based on a survey conducted by Abbott December, 2017 of physicians treating cryptogenic stroke

Cryptogenic Stroke Overview

Cryptogenic Stroke Overview

Cryptogenic Stroke Overview

AN EVERYDAY OCCURRENCE

  • Approximately one-third of ischemic strokes are cryptogenic1
  • Each year, there are approximately 200,000 and 300,000 strokes in the US and the EU, respectively1,2

MULTIPLE POTENTIAL MECHANISMS

  • Several mechanisms are implicated in patients with cryptogenic stroke, including but not limited to:
    • Occult paroxysmal AF2
    • Paradoxical embolism through a PFO2
    • Substenotic atherosclerosis2

HIGHER PREVALENCE OF PFO

  • Prevalence of PFO in the general population is reported between 17%-35%3
  • In patients with cryptogenic stroke, PFO was found in up to 45% of cases3

POTENTIAL FOR RECURRENCE

  • Rate of stroke recurrence in patients with PFO has been estimated to be 20.4% at 3 years3 and 25% at 4 years4,5
  • Patients with PFO and prior cryptogenic stroke have a higher risk for further cerebrovascular events6

Cryptogenic Stroke

A RELATIVELY YOUNG PATIENT POPULATION

  • Cryptogenic stroke is common in patients under 45 years of age7
  • PFO is strongly associated with cryptogenic stroke in patients younger than 55 years8
  • Even a relatively low recurrence rate may pose a substantial risk with the potential for a longer exposure period9
Testimonial: Heidi Easley

TERRIFIED OF HAVING ANOTHER STROKE

“Having no control is so scary. Walking around in fear of having another stroke, or being on major blood thinners forever. I just wanted to live a normal life without constant worry.”

Testimonial: Heidi Easley

–Heidi Easley, cryptogenic stroke patient at 37

This testimonial relates an account of an individual’s response to the treatment. This patient’s account is genuine, typical and documented. However, it does not provide any indication, guide, warranty or guarantee as to the response other persons may have to the treatment. Responses to the treatment discussed can and do vary and are specific to the individual patient.

THE SOLUTION: PFO CLOSURE

References:

  1. Truelsen T, Piechowski-Jozwiak B, Bonita R, Mathers C, Bogousslavsky J, Boysen G. Stroke incidence and prevalence in Europe: a review of available data. Eur J Neurol. 2006;13:581-598.
  2. Mozaffarian D, Benjamin E, Go A, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133:e38-e360.
  3. Preventive Cardiology What Proportion of Stroke Is Not Explained by Classic Risk Factors? Catalina C. Ionita, MD; Andrew R. Xavier, MD; Jawad F. Kirmani, MD; Subasini Dash, MD; Afshin A. Divani, PhD; Adnan I. Qureshi, MD Disclosures Prev Cardiol. 2005;8(1):41-46.
  4. Homma S., Sacco R.L., Di Tullio M.R., et al., for the PICSS Investigators (2002) Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation. 105:2625–2631. Abstract/FREE Full TextGoogle Scholar
  5. Mas J-L, Derumeaux G, Guillon B, et al. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med. 2017;377:1011-21 and supplementary appendix.
  6. Kernan et al. AHA/ASA Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke. 2014; 45(7):2160-2236.
  7. Ionita. Preventive Cardiology: https://www.medscape.com/viewarticle/499978_6
  8. Handke M, Harloff A, Olschewski M, Hetzel A, Geibel A. Patent foramen ovale and cryptogenic stroke in older patients. N Engl J Med. 2007;357:2262-8.
  9. Love BA, Diener H. PFO: “Please figure out,” or now “Potentially Figured Out?” JACC