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Determinants of adverse outcomes following patent foramen ovale closure in elderly patients.
Farjat-Pasos, Julio I; Guedeney, Paul; Horlick, Eric; Abtan, Jeremie; Nombela-Franco, Luis; Hibbert, Benjamin; Sondergaard, Lars; Freixa, Xavier; Masson, Jean-Bernard; Cruz-González, Ignacio; Estévez-Loureiro, Rodrigo; Faroux, Laurent; Shah, Ashish H; Abrahamyan, Lusine; Mesnier, Jules; Jerónimo, Adrián; Abdel-Razek, Omar; Jørgensen, Troels Højsgaard; Asmar, Mike Al; Sitbon, Samuel; Abalhassan, Mohammed; Robichaud, Mathieu; Houde, Christine; Côté, Mélanie; Chamorro, Angel; Lanthier, Sylvain; Verreault, Steve; Montalescot, Gilles; Rodés-Cabau, Josep.
Afiliación
  • Farjat-Pasos JI; Cardiology Department, Quebec Heart and Lung Institute, Québec, QC, Canada.
  • Guedeney P; Pediatric Cardiology Department, Centre Hospitalier Universitaire de Québec, Québec, QC, Canada.
  • Horlick E; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie (AP-HP), Paris, France.
  • Abtan J; Cardiology Department, Toronto General Hospital, Toronto, ON, Canada.
  • Nombela-Franco L; Cardiology Department, Bichat-Claude-Bernard Hospital, Paris, France.
  • Hibbert B; Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
  • Sondergaard L; Cardiology Department, Ottawa Heart Institute, Ottawa, ON, Canada.
  • Freixa X; Cardiology Department, Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Masson JB; Cardiology Department, Hospital Clinic of Barcelona, Barcelona, Spain.
  • Cruz-González I; Cardiology Department, University of Montreal Health Centre, Montreal, QC, Canada.
  • Estévez-Loureiro R; Cardiology Department, University Hospital of Salamanca, IBSAL, CIBER-CV, Salamanca, Spain.
  • Faroux L; Cardiology Department, University Hospital Complex of Vigo, Vigo, Spain.
  • Shah AH; Cardiology Department, Reims University Hospital, Reims, France.
  • Abrahamyan L; Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
  • Mesnier J; Cardiology Department, Toronto General Hospital, Toronto, ON, Canada.
  • Jerónimo A; Cardiology Department, Bichat-Claude-Bernard Hospital, Paris, France.
  • Abdel-Razek O; Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
  • Jørgensen TH; Cardiology Department, Ottawa Heart Institute, Ottawa, ON, Canada.
  • Asmar MA; Cardiology Department, Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Sitbon S; Cardiology Department, University of Montreal Health Centre, Montreal, QC, Canada.
  • Abalhassan M; Cardiology Department, Bichat-Claude-Bernard Hospital, Paris, France.
  • Robichaud M; Cardiology Department, Ottawa Heart Institute, Ottawa, ON, Canada.
  • Houde C; Cardiology Department, Quebec Heart and Lung Institute, Québec, QC, Canada.
  • Côté M; Pediatric Cardiology Department, Centre Hospitalier Universitaire de Québec, Québec, QC, Canada.
  • Chamorro A; Cardiology Department, Quebec Heart and Lung Institute, Québec, QC, Canada.
  • Lanthier S; Neuroscience Department, Hospital Clinic of Barcelona, Barcelona, Spain.
  • Verreault S; Neurovascular Program and Research Center, Hôpital du Sacré-Coeur-de-Montréal, Montreal, QC, Canada.
  • Montalescot G; Neurovascular Department, Centre Hospitalier Universitaire de Québec, Québec, QC, Canada.
  • Rodés-Cabau J; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie (AP-HP), Paris, France.
EuroIntervention ; 20(16): 1029-1038, 2024 Aug 19.
Article en En | MEDLINE | ID: mdl-39155753
ABSTRACT

BACKGROUND:

Limited data are available on transcatheter patent foramen ovale (PFO) closure outcomes in the elderly.

AIMS:

Through this study, we aimed to determine the incidence and predictors of adverse events (recurrent cerebrovascular events [CVE] and atrial fibrillation [AF]) post-PFO closure in older patients with cryptogenic events.

METHODS:

This multicentre international study included patients over 60 years undergoing PFO closure for cryptogenic thromboembolic events. A dedicated database compiled baseline, procedural, and follow-up data. Competing risk and adjusted outcome predictor analyses were conducted.

RESULTS:

A total of 689 patients were included (median age 65 years, 41.2% female, mean Risk of Paradoxical Embolism [RoPE] score 4.5). The procedural success rate was 99.4%. After a median follow-up of 2 (interquartile range 1-5) years, 66 patients (9.6%) had died. CVE and stroke rates were 1.21 and 0.55 per 100 patient-years, respectively. Diabetes (hazard ratio [HR] 3.89, 95% confidence interval [CI] 1.67-9.07; p=0.002) and atrial septal aneurysm (ASA; HR 5.25, 95% CI 1.56-17.62; p=0.007) increased the CVE risk. New-onset AF occurred at a rate of 3.30 per 100 patient-years, with 51.3% within one month post-procedure. Older age (HR 1.05 per year, 95% CI 1.00-1.09; p=0.023) and the absence of hypertension (HR 2.04, 95% CI 1.19-3.57; p=0.010) were associated with an increased risk of AF.

CONCLUSIONS:

Older patients undergoing PFO closure had a relatively low rate of CVE and new-onset AF after a median follow-up of 2 years. The presence of diabetes, ASA, and a more advanced age determined an increased risk of adverse clinical events. These factors may be considered in the clinical decision-making process regarding PFO closure in this challenging population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Cateterismo Cardíaco / Foramen Oval Permeable Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: EuroIntervention Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Cateterismo Cardíaco / Foramen Oval Permeable Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: EuroIntervention Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Francia