SynthesisCardiology journal2019
Patent foramen ovale closure versus medical therapy after cryptogenic stroke: An updated meta-analysis of all randomized clinical trials.
Synthesis in Cardiology journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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
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Who cites it
13 citing papers in PubMed, 22 citations in OpenAlex.
- Incidence and outcome of paediatric cardioembolic stroke: a nationwide population-based study.European stroke journal · 2026Article
- Antithrombotic Therapy in Percutaneous Atrial Structural Interventions.Journal of cardiovascular development and disease · 2026Review
- Cost-Effectiveness and Budget Impact of Cardioform versus Amplatzer and Medical Therapy Alone for Patent Foramen Ovale Closure: A UK Payer Perspective.ClinicoEconomics and outcomes research : CEOR · 2026Article
- Transcatheter atrial septal defects and patent foramen ovale closure: Medicare utilization and reimbursements.World journal of methodology · 2025Article
- Patent foramen ovale diagnosis in young stroke patients: analysis of recurrence and mortality.Journal of neurology · 2025Article
- Review
- Sex Differences in Patients With Cryptogenic Cerebrovascular Events Undergoing Transcatheter Closure of Patent Foramen Ovale.Journal of the American Heart Association · 2023Article
- Secondary Prevention of Cryptogenic Stroke and Outcomes Following Surgical Patent Foramen Ovale Closure Plus Medical Therapy vs. Medical Therapy Alone: An Umbrella Meta-Analysis of Eight Meta-Analyses Covering Seventeen Countries.Cardiology research · 2023Article
- Transesophageal echocardiography-guided percutaneous closure of the patent foramen ovale only uses the sheath.Cardiovascular diagnosis and therapy · 2023Article
- Patent Foramen Ovale and Cryptogenic Stroke: Integrated Management.Journal of clinical medicine · 2023Review
- Percutaneous Patent Foramen Ovale Closure in Patients with Cryptogenic Stroke or Transient Ischemic Attack: A Retrospective Study.BioMed research international · 2022Article
- European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Article
- The effectiveness of risk mitigation interventions in divers with persistent (patent) foramen ovale.Diving and hyperbaric medicine · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCryptogenic strokes can be attributed to paradoxical emboli through patent foramen ovale (PFO). However, the effectiveness of PFO closure in preventing recurrent stroke is uncertain and the results of previous randomized clinical trials (RCTs) have been inconclusive. Hence, this study pro- vides an updated meta-analysis of all RCTs comparing PFO closure with medical therapy for secondary prevention of cryptogenic stroke.
methodsAll RCTs were identified by a comprehensive literature search of PubMed, Embase, the Cochrane Collaboration Central Register of Controlled Trials, Scopus, and Clinicaltrials.gov. The primary outcome was recurrent ischemic stroke and secondary outcomes were transient ischemic at- tack (TIA), all-cause mortality, new-onset atrial fibrillation (AF), serious adverse events, and major bleeding.
resultsFive RCTs with 3440 participants were included in the present study (1829 patients under- went PFO closure and 1611 were treated medically). Pooled analysis showed a statistically significant reduction in the rate of recurrent stroke with PFO closure in comparison to medical therapy (OR 0.41; 95% CI 0.19-0.90; p = 0.03). However, there were no statistically significant reductions of recurrent TIAs (OR 0.77; 95% CI 0.51-1.14; p = 0.19) or all-cause mortality (OR 0.76; 95% CI 0.35-1.65; p = 0.48). The risk of developing new-onset AF was increased significantly with PFO closure (OR 4.74; 95% CI 2.33-9.61; p < 0.0001), but no significant differences in terms of serious adverse events or major bleeding between both groups.
conclusionsPatent foramen ovale closure in adults with recent cryptogenic stroke was associated with a lower rate of recurrent strokes in comparison with medical therapy alone.
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