The Role of Patent Foramen Ovale Closure in the Secondary Prevention of Cryptogenic Stroke: a Meta-Analysis Report
Int. j. cardiovasc. sci. (Impr.)
;
33(4): 307-317, July-Aug. 2020. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-1134380
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.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Accident vasculaire cérébral
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Foramen ovale perméable
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Prévention secondaire
Type d'étude:
Essai clinique contrôlé
/
Etude d'étiologie
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Facteurs de risque
/
Revues systématiques évaluées
langue:
Anglais
Texte intégral:
Int. j. cardiovasc. sci. (Impr.)
Thème du journal:
Cardiologie
Année:
2020
Type:
Article
Pays d'affiliation:
Portugal
/
États-Unis d'Amérique
Institution/Pays d'affiliation:
Universidade do Porto/PT
/
University of Pennsylvania/US
/
Universitário São João/PT
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