Evidence map›Paper›PMID 32518658›Full record

ArticleOpen heart2020

Prognostic significance of patent foramen ovale in anticoagulated patients with atrial fibrillation.

Rowlens M Melduni, Waldemar E Wysokinski, Zhenzhen Wang, Bernard J Gersh, Samuel J Asirvatham, Sri Harsha Patlolla, Eddie L Greene, Jae K Oh, Hon-Chi Lee

Open access · goldAbstract read
In one paragraph

Article in Open heart, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 50% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Rowlens M MelduniCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0001-7074-6164
Waldemar E WysokinskiCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Zhenzhen WangCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Bernard J GershCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Samuel J AsirvathamCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Sri Harsha PatlollaCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Eddie L GreeneMedicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Jae K OhCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Hon-Chi LeeCardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Clinic · US

Funding

The Role of Autoimmune Mechanisms in the Pathogenesis of Atrial FibrillationK01HL135288 · NHLBI · MAYO CLINIC ROCHESTER · PI MELDUNI, ROWLENS MICHEL · 2017 to 2021
$854k
NHLBI NIH HHS K01 HL135288
6 · The paper itself

Abstract

Objective: Previous studies have postulated a causal role of patent foramen ovale (PFO) in the aetiology of embolic stroke in the general population. We hypothesised that the presence of concomitant PFO and atrial fibrillation (AF) will add incremental risk of ischaemic stroke to that linked to AF alone. Methods: We analysed data on 3069 consecutive patients (mean age 69.4±12.2 years; 67.1% men) undergoing transoesophageal echocardiography-guided electrical cardioversion (ECV) for AF between May 2000 and March 2012. PFO was identified by colour Doppler and agitated saline contrast study. All patients were followed up after ECV for first documentation of ischaemic stroke. Outcomes were compared using Cox regression models. Results: The prevalence of PFO was 20.0% and the shunt direction was left-to-right in the majority of patients (71.4%). Patients with PFO had a higher frequency of obstructive sleep apnoea (21.7% vs 17.1%, p=0.01) and higher mean peak left atrial appendage emptying velocity (38.3±21.8 vs 36.1±20.4 cm/s; p=0.04) compared with those without PFO. Otherwise, baseline characteristics were similar between groups. During a mean follow-up period of 7.3±4.6 years, 214 patients (7.0%) had ischaemic stroke. Multivariable analysis showed no significant association between PFO and ischaemic stroke (HR, 0.82 (95% CI 0.57 to 1.18)). PFO shunt direction was strongly associated with stroke: HR, 1.91 (95% CI 1.16 to 3.16) for right-to-left shunt and HR, 0.58 (95% CI 0.36 to 0.93) for left-to-right shunt. Conclusions: The presence of concurrent PFO in this largely anticoagulated group of patients with AF was not associated with increased risk of ischaemic stroke.

Indexed as

AgedAged, 80 and overAnticoagulantsAtrial FibrillationEchocardiography, Doppler, ColorFemaleForamen Ovale, PatentHumansMaleMiddle AgedMinnesotaPrevalenceProspective StudiesRisk AssessmentRisk FactorsStrokeAnticoagulantsatrial fibrillationatrial flutterechocardiographyelectrocardiographystroke

Identifiers

PMID32518658
PMCPMC7254151
OpenAlexW3016168947

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.