SynthesisJournal of neurology2018
Patent foramen ovale closure versus medical therapy in cases with cryptogenic stroke, meta-analysis of randomized controlled trials.
Synthesis in Journal of neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Secondary prevention of cryptogenic stroke in patients with patent foramen ovale: a systematic review and meta-analysis.Internal and emergency medicine · 2018Pooled it
- Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta-analysis of 5 randomized controlled trials and 14 observational studies.CNS neuroscience & therapeutics · 2018Pooled it
- Ischaemic stroke in young adults: an overview of the classification, risk factors, aetiologies and outcomes.Singapore medical journal · 2026Review
- Migraine and patent foramen ovale: correlation, coexistence, dependence. A narrative review.Headache · 2026Review
- Patent foramen ovale diagnosis in young stroke patients: analysis of recurrence and mortality.Journal of neurology · 2025Article
- Case Report: Is there an age cutoff beyond which PFO closure should not be offered?Frontiers in cardiovascular medicine · 2025Article
- Patent Foramen Ovale (PFO): History, Diagnosis, and Management.Reviews in cardiovascular medicine · 2024Review
- Sex Differences in Patients With Cryptogenic Cerebrovascular Events Undergoing Transcatheter Closure of Patent Foramen Ovale.Journal of the American Heart Association · 2023Article
- Cerebrovascular Events in Older Patients With Patent Foramen Ovale: Current Status and Future Perspectives.Journal of stroke · 2023Review
- Article
- Patent foramen ovale-When to close and how?Herz · 2021Review
- Patient with systemic emboli in the setting ofBMJ case reports · 2021Article
- Stroke in young adults: Current trends, opportunities for prevention and pathways forward.American journal of preventive cardiology · 2020Review
- Patent Foramen Ovale Closure: State of the Art.Interventional cardiology (London, England) · 2020Review
- Patent Foramen Ovale Closure in 2019.Interventional cardiology (London, England) · 2019Review
- Cryptogenic stroke and patent foramen ovale (abridged and translated version).Neurological research and practice · 2019Article
- Article
- [Cryptogenic stroke and patent foramen ovale : S2e guidelines].Der Nervenarzt · 2018Review
- [Patent foramen ovale-intervention or pharmaceutical treatment].Der Internist · 2018Review
- Patent foramen ovale and stroke.Journal of neurology · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPFO is more common in cases with cryptogenic stroke compared to cases with no stroke or stroke of identified etiology. Several randomized controlled trials (RCTs) comparing PFO closure with medical therapy have been published with controversial findings.
methodsPubMed, Embase and Cochrane library databases were searched for RCT comparing PFO closure with medical therapy including antiplatelet therapy (aspirin or clopidogrel or combination) or anticoagulation. We identified 5 trials, including 3627 cases. The mean duration of follow-up was 4 years. Relative risk (RR) and 95% confidence intervals (CI) were calculated using fixed and random-effects models.
resultsThere was a significant reduction in the incidence of stroke among the PFO closure group compared to medical therapy group, 2.0 versus 4.2%, RR 0.48; 95% CI (0.3, 0.7), p < 0.001. The incidence of AF was higher in the PFO closure group compared to medical therapy group, 4.2 versus 0.7%, respectively, RR 5.9, 95% CI (3, 11), p < 0.001. After exclusion of oral anticoagulants cases (19%), analysis showed a lower incidence of stroke in the PFO closure group (2%) compared to antiplatelet therapy (5.2%), RR 0.4; 95% CI (0.3, 0.6), p < 0.001. There was no significant difference between both groups in the incidence of transient ischemic attacks or all-cause deaths.
conclusionPFO closure results in a significant reduction in the recurrence of ischemic stroke compared to medical therapy alone, primarily antiplatelet, among cases with PFO and cryptogenic stroke.
Indexed as
Identifiers
29356972What OpenQuestion holds
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.