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Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
Yonsei Medical Journal ; : 621-625, 2016.
Article Dans Anglais | WPRIM | ID: wpr-21854
ABSTRACT

PURPOSE:

To compare the effectiveness of device closure and medical therapy in prevention of recurrent embolic event in the Korean population with cryptogenic stroke and patent foramen ovale (PFO). MATERIALS AND

METHODS:

Consecutive 164 patients (men 126 patients, mean age 48.1 years, closure group 72 patients, medical group 92 patients) were enrolled. The primary end point was a composite of death, stroke, transient ischemic attack (TIA), or peripheral embolism.

RESULTS:

Baseline characteristics were similar in the two groups, except age, which was higher in the medical group (45.3±9.8 vs. 50.2±6.1, p<0.0001), and risk of paradoxical embolism score, which was higher in the closure group (6.2±1.6 vs. 5.7±1.3, p=0.026). On echocardiography, large right-to-left shunt (81.9% vs. 63.0%, p=0.009) and shunt at rest/septal hypermobility (61.1% vs. 23.9%, p<0.0001) were more common in the closure group. The device was successfully implanted in 71 (98.6%) patients. The primary end point occurred in 2 patients (2 TIA, 2.8%) in the closure group and in 2 (1 death, 1 stroke, 2.2%) in the medical group. Event-free survival rate did not differ between the two groups.

CONCLUSION:

Compared to medical therapy, device closure of PFO in patients with cryptogenic stroke did not show difference in reduction of recurrent embolic events in the real world's setting. However, considering high risk of echocardiographic findings in the closure group, further investigation of the role of PFO closure in the Asian population is needed.
Sujets)

Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Cathétérisme cardiaque / Accident ischémique transitoire / Risque / Résultat thérapeutique / Survie sans rechute / Accident vasculaire cérébral / Embolie / Foramen ovale perméable / Prévention secondaire / Dispositif d&apos;occlusion septale Type d'étude: Etude d'étiologie / Facteurs de risque Limites du sujet: Adulte / Adulte très âgé / Aged80 / Femelle / Humains / Mâle Pays comme sujet: Asie langue: Anglais Texte intégral: Yonsei Medical Journal Année: 2016 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Cathétérisme cardiaque / Accident ischémique transitoire / Risque / Résultat thérapeutique / Survie sans rechute / Accident vasculaire cérébral / Embolie / Foramen ovale perméable / Prévention secondaire / Dispositif d&apos;occlusion septale Type d'étude: Etude d'étiologie / Facteurs de risque Limites du sujet: Adulte / Adulte très âgé / Aged80 / Femelle / Humains / Mâle Pays comme sujet: Asie langue: Anglais Texte intégral: Yonsei Medical Journal Année: 2016 Type: Article