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
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| ID: biblio-1134380
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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.Palavras-chave
Texto completo:
1
Índice:
LILACS
Assunto principal:
Acidente Vascular Cerebral
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Forame Oval Patente
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Prevenção Secundária
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Risk_factors_studies
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Systematic_reviews
Idioma:
En
Revista:
Int. j. cardiovasc. sci. (Impr.)
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article