SynthesisClinical research in cardiology : official journal of the German Cardiac Society2018
Patent foramen ovale closure or medical therapy for cryptogenic ischemic stroke: an updated meta-analysis of randomized controlled trials.
Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Interventional closure vs. medical therapy of patent foramen ovale for secondary prevention of stroke: updated meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Pooled it
- [Cardiopulmonary resuscitation-induced consciousness (CPRIC) : Consciousness in cardiopulmonary resuscitation: intra-arrest sedation and immediate extubation with spontaneous circulation].Die Anaesthesiologie · 2025Review
- Atrial Fibrillation After Patent Foramen Ovale Closure: Incidence, Pathophysiology, and Management.Journal of the American Heart Association · 2024Review
- [Arterial ischemic stroke in childhood and adolescence : Time-critical emergency in pediatrics].Der Nervenarzt · 2022Article
- [Stroke alarm-Arterial ischemic stroke as one of the most time-critical emergencies in children and adolescents].Der Nervenarzt · 2022Review
- An Artificial Intelligence-Enabled Pipeline for Medical Domain: Malaysian Breast Cancer Survivorship Cohort as a Case Study.Diagnostics (Basel, Switzerland) · 2021Article
- Treatment Strategies for Cryptogenic Stroke Patients with Patent Foramen Ovale: What Do We Choose?Neuropsychiatric disease and treatment · 2021Article
- Patent Foramen Ovale Closure: State of the Art.Interventional cardiology (London, England) · 2020Review
- Closure of patent foramen ovale for secondary prevention of cryptogenic stroke: current perspectives.Archives of medical science : AMS · 2020Article
- Article
- Lipoprotein-Associated Phospholipase A2 is Linked with Poor Cardio-Metabolic Profile in Patients with Ischemic Stroke: A Study of Effects of Statins.Journal of neurosciences in rural practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious randomized controlled trials (RCT) failed to demonstrate benefits of patent foramen ovale (PFO) closure (PFO-C) over medical therapy (MT) for secondary prevention of cryptogenic ischemic stroke. Three recently published RCTs, however, turned out positive for PFO-C and warrant an updated meta-analysis.
methodsData from all available RCTs on PFO-C vs. MT for secondary prevention of cryptogenic ischemic stroke up until October 2017 were abstracted and analyzed in a comprehensive meta-analysis. Clinical efficacy outcomes were recurrent stroke, recurrent TIA, and their combination; safety outcomes were mortality, major bleeding, venous thromboembolism (VTE), and new-onset atrial fibrillation/flutter (NOAF).
resultsFive trials including a total of 3440 patients were included in the meta-analysis. PFO-C significantly reduced recurrent stroke [odds ratio (OR) 0.41, 95% confidence interval (CI) 0.19-0.90; p = 0.03] and the combination of recurrent stroke + TIA (OR 0.53, CI 0.36-0.80; p = 0.002) compared to MT; recurrent TIA alone showed no differences (OR 0.77; CI 0.51-1.14; p = 0.19). NOAF was significantly more frequent after PFO-C (OR 5.75, CI 3.09-10.70; p < 0.00001). Mortality (OR 0.80, CI 0.39-1.67), major bleeding (OR 0.96, CI 0.48-1.92), and VTE (OR 2.45, CI 0.75-7.99) remained neutral. Trials with superior patient selection for PFO-C showed advantageous results compared to MT.
conclusionsPFO-C after cryptogenic ischemic stroke is safe and effective to reduce the risk of recurrent stroke and recurrent stroke + TIA, albeit with an increased risk for NOAF.
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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.