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The Role of Patent Foramen Ovale Closure in the Secondary Prevention of Cryptogenic Stroke: a Meta-Analysis Report
Pereira, Sónia P. Pinto; Nunes, Alzira; Santos, Cristina; Kasner, Scott E; Nunes, José P. L.
Afiliación
  • Pereira, Sónia P. Pinto; Universidade do Porto. Faculdade de Medicina. Porto. PT
  • Nunes, Alzira; Universitário São João. Centro Hospitalar. Porto. PT
  • Santos, Cristina; Universidade do Porto. Faculdade de Medicina. Porto. PT
  • Kasner, Scott E; University of Pennsylvania. Philadelphia. US
  • Nunes, José P. L; Universidade do Porto. Faculdade de Medicina. Porto. PT
Int. j. cardiovasc. sci. (Impr.) ; 33(4): 307-317, July-Aug. 2020. tab, graf
Article en En | LILACS | ID: biblio-1134380
Biblioteca responsable: BR1.1
ABSTRACT
Abstract

Background:

Patent foramen ovale (PFO) closure has been compared to medical therapy for secondary prevention of recurrent cryptogenic stroke.

Objectives:

To produce an updated meta-analysis including only data from the primary analyses of clinical trials and to evaluate the role of PFO closure in the secondary prevention of recurrent stroke.

Methods:

Search in Medline (PubMed) and in ISI Web of Knowledge. Parameters under analysis and meta-analyses were stroke, transient ischemic attack (TIA) and atrial fibrillation (AF). Comprehensive Meta-analysis Software V.2.0 (Biostat) was used. Random-effects analyses were carried out. A level of significance of 5% was used.

Results:

In this study six, randomized trials enrolling 3,750 patients were included. Unlike other published meta-analyses on the same topic, in this case, only clinical trial data, and not follow-up data, were used. PFO closure, as compared with medical therapy alone, demonstrated superiority in reducing the rate of recurrent stroke (risk ratio with PFO closure vs. medical therapy, 0.37; 95% confidence interval [CI], 0.17 to 0.78; p = 0.01). PFO closure did not offer a significant benefit in prevention of TIA (risk ratio with PFO closure vs. medical therapy, 0.96; 95% CI, 0.64 to 1.44; p = 0.85). Among patients assigned to closure group, an increased risk of atrial fibrillation was seen (risk ratio with PFO closure vs. medical therapy, 4.64; 95% CI, 2.38 to 9.01; p < 0.01).

Conclusions:

In patients with cryptogenic stroke who had a patent foramen ovale, a protective effect of closure was seen concerning the risk of recurrent stroke, but not regarding the prevention of TIA.
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Texto completo: 1 Colección: 01-internacional Base de datos: LILACS Asunto principal: Accidente Cerebrovascular / Foramen Oval Permeable / Prevención Secundaria Tipo de estudio: Clinical_trials / Etiology_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Int. j. cardiovasc. sci. (Impr.) Asunto de la revista: CARDIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Portugal / Estados Unidos Pais de publicación: Brasil
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: LILACS Asunto principal: Accidente Cerebrovascular / Foramen Oval Permeable / Prevención Secundaria Tipo de estudio: Clinical_trials / Etiology_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Int. j. cardiovasc. sci. (Impr.) Asunto de la revista: CARDIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Portugal / Estados Unidos Pais de publicación: Brasil