Evidence map›Paper›PMID 29229471›Full record

SynthesisThe American journal of medicine2018

Patent Foramen Ovale Closure for Secondary Prevention of Cryptogenic Stroke: Updated Meta-Analysis of Randomized Clinical Trials.

Muthiah Vaduganathan, Arman Qamar, Ankur Gupta, Navkaranbir Bajaj, Harsh B Golwala, Ambarish Pandey, Deepak L Bhatt

Registry-linked trialOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The American journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06504121 (PFO tRanscatether Occlusion Long-term Outcomes National Group), which is not on this map. Cited by 15 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06504121 completednot on this map

PFO tRanscatether Occlusion Long-term Outcomes National Group (PROLONG) Registry

TypeobservationalSponsorIRCCS Ospedale San RaffaeleRan1999 to 2024Enrolled1,360ConditionsPatent Foramen Ovale, Stroke, Cryptogenic, Transient Ischaemic Attack Due to Embolism, Atrial Fibrillation New OnsetArmsSeptal Occluder Device
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
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  4. Stroke and transient ischemic attack recurrence after PFO closure in patients with cryptogenic embolism.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Muthiah VaduganathanBrigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Mass.
Arman QamarBrigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Mass.
Ankur GuptaBrigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Mass.
Navkaranbir BajajBrigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Mass.
Harsh B GolwalaBrigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Mass.
Ambarish PandeyDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, Tex.
Deepak L BhattBrigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Mass. Electronic address: dlbhattmd@post.harvard.edu.
Brigham and Women's Hospital · USThe University of Texas Southwestern Medical Center · US

Funding

TRAINING PROGRAM IN CARDIOVASCULAR RESEARCHT32HL007604 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MARK W FEINBERG · 1985 to 2026
$19.0M
Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
NHLBI NIH HHS T32 HL007604NHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

backgroundPatent foramen ovale closure represents a potential secondary prevention strategy for cryptogenic stroke, but available trials have varied by size, device studied, and follow-up.

methodsWe conducted a systematic search of published randomized clinical trials evaluating patent foramen ovale closure versus medical therapy in patients with recent stroke or transient ischemic attack using PubMED, EMBASE, and Cochrane through September 2017. Weighting was by random effects models.

resultsOf 480 studies screened, we included 5 randomized clinical trials in the meta-analysis in which 3440 patients were randomized to patent foramen ovale closure (n = 1829) or medical therapy (n = 1611) and followed for an average of 2.0 to 5.9 years. Index stroke/transient ischemic attack occurred within 6 to 9 months of randomization. The primary end point was composite stroke/transient ischemic attack and death (in 3 trials) or stroke alone (in 2 trials). Patent foramen ovale closure reduced the primary end point (0.70 vs 1.48 events per 100 patient-years; risk ratio [RR], 0.52 [0.29-0.91]; I

conclusionsIn patients with recent cryptogenic stroke, patent foramen ovale closure reduces recurrent stroke/transient ischemic attack compared with medical therapy, but is associated with a higher risk of new-onset atrial fibrillation/flutter.

Indexed as

Secondary PreventionAnticoagulantsAtrial FibrillationAtrial FlutterForamen Ovale, PatentHumansIschemic Attack, TransientPlatelet Aggregation InhibitorsPostoperative ComplicationsRandomized Controlled Trials as TopicStrokeAnticoagulantsPlatelet Aggregation InhibitorsCryptogenic strokeMeta-analysisPatent foramen ovalePercutaneous

Identifiers

PMID29229471
PMCPMC5910216
OpenAlexW2773979568

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.