[Identification of potential influencing factors associated with elimination of migraine headache in patients with PFO after percutaneous closure].

Objective: To recognize the potential factors that contribute to the eradication of migraine headache in patients with patent foramen ovale (PFO) at one year after percutaneous closure. Methods: A prospective cohort study was conducted, which enrolled patients diagnosed with migraines and PFO at the Department of Structural Heart Disease, First Affiliated Hospital of Xi'an Jiaotong University between May 2016 and May 2018. The patients were segregated into two groups based on their response to treatment, and one group showed elimination of migraines while another did not. Elimination of migraines was defined as a Migraine Disability Assessment Score (MIDAS) score of 0 at one year postoperatively. Least Absolute Shrinkage and Selection Operator (LASSO) regression model was utilized to identify the predictive variables for migraine elimination post-PFO closure. Multiple logistic regression analysis was employed to determine the independent predictive factors. Results: The study enrolled a total of 247 patients, with an average age of (37.5±13.6) years, comprising 81 male individuals (32.8%). One year after closure, 148 patients (59.9%) reported eradication of their migraines. Multivariate logistic regression analysis revealed that migraine with or without aura (OR=0.003 9, 95%CI 0.000 2-0.058 7, P=0.000 18), a history of antiplatelet medication use (OR=0.088 2, 95%CI 0.013 7-0.319 3, P=0.001 48) and resting right-to-left shunt (RLS) (OR=6.883 6, 95%CI 3.769 2-13.548 0, P<0.001) were identified as independent predictive factors for elimination of migraine. Conclusion: Migraine with or without aura, a history of antiplatelet medication use, and resting RLS are the independent prognostic factors associated with elimination of migraine. These results provide important clues for clinicians to choose the optimal treatment plan for PFO patients. However, further studies are needed to confirm these findings.目的： 探讨卵圆孔未闭（PFO）患者经皮封堵术后1年偏头痛完全缓解的影响因素。 方法： 本研究为前瞻性队列研究。入选2016年5月至2018年5月就诊于西安交通大学第一附属医院结构性心脏病科诊断为PFO的头痛患者。根据患者术后1年偏头痛是否完全缓解，分为完全缓解组和未完全缓解组。偏头痛完全缓解定义为封堵术后1年时偏头痛残疾评估评分（MIDAS）为0。使用最小绝对收缩和选择算子（LASSO）回归模型筛选预测变量，采用多因素logistic回归分析PFO封堵术后偏头痛完全缓解的独立预测因素。 结果： 共纳入247例患者，年龄（37.5±13.6）岁，其中男性81例（32.8%）。术后1年共有148例（59.9%）患者偏头痛完全缓解。多因素logistic回归分析显示偏头痛有无先兆（OR=0.003 9，95%CI 0.000 2~0.058 7，P=0.000 18）、抗血小板用药史（OR=0.088 2，95%CI 0.013 7~0.319 3，P=0.001 48）和静息时右向左分流（OR=6.883 6，95%CI 3.769 2~13.548 0，P<0.001）是偏头痛完全缓解的独立预测因素。 结论： 偏头痛有无先兆、抗血小板用药史以及静息时右向左分流是术后偏头痛完全缓解的预测因素。这些结果提供了临床医生为PFO患者选择最佳治疗方案的重要线索。然而，需要进一步的研究来确认这些发现。.