Author + information
- Mannu Nayyar,
- Beatrix Ramos Bondy,
- Namratha Reddy and
- Rahman Shah
Epidemiologic studies suggest that patent foramen ovale (PFO) is associated with cryptogenic stroke, especially in younger patients. However, three early randomized controlled trials (RCTs) failed to prove the superiority of PFO closure compared to medical therapy alone. One of the main limitations of those RCTs was the small number of events during the follow-up, raising the possibility of a ‘type 2 error’. In recent months, two new RCTs and a long-term follow up study of one of the early trials have been reported. Therefore, we performed an updated meta-analysis of RCTs, which included the most recent follow-up data and represents the largest sample size to date.
Relevant RCTs were included and risk ratio (RR) were calculated using random effect models.
Five RCTs involving 3801 patients were included in the analysis. Compared to medical therapy alone, device closure decreased recurrent stroke risk by 55%, but did not affect the rate of TIA, bleeding, or death.
Device closure was also associated with an increased incidence of new-onset atrial fibrillation and procedure-related vascular complications (Fig 1).
In patients with cryptogenic stroke, device closure for PFO decreases recurrent risk of stroke and increases incidence of atrial fibrillation compared to medical therapy alone.
Moderated Poster Contributions
Congenital Heart Disease and Pulmonary Hypertension Moderated Poster Theater, Poster Hall, Hall A/B
Monday, March 12, 2018, 1:00 p.m.-1:10 p.m.
Session Title: Trends in Hospitalization For Congenital Heart Disease
Abstract Category: 09. Congenital Heart Disease: Adult
Presentation Number: 1322M-07
- 2018 American College of Cardiology Foundation