| Recurrent cerebral ischemia in medically treated patent foramen ovale: a meta-analysis. | |
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MedLine Citation:
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PMID: 19439720 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Among patients with a patent foramen ovale (PFO) and a prior cryptogenic ischemic stroke or TIA, the absolute and relative risk of recurrent events is unclear. METHODS: We conducted a systematic review and meta-analysis of clinical studies in any language published up to February 2008. We included studies reporting original data on recurrent cerebrovascular events in patients with prior cryptogenic stroke or TIA and PFO. Two authors independently extracted data and evaluated study quality. RESULTS: We identified 15 eligible studies, four with a non-PFO comparison group. In these four studies, the pooled relative risk (RR) for recurrent ischemic stroke or TIA in patients with vs without a PFO was 1.1 (95% confidence interval [CI] 0.8 to 1.5). For ischemic stroke, the pooled RR was 0.8 (95% CI 0.5 to 1.3). We tabulated the absolute rate of recurrent events in all 15 studies. The pooled absolute rate of recurrent ischemic stroke or TIA in patients with PFO was 4.0 events per 100 person-years (95% CI 3.0 to 5.1) while the rate of recurrent ischemic stroke was 1.6 events per 100 person-years (95% CI 1.1 to 2.1). CONCLUSIONS: In medically treated patients with prior cryptogenic stroke, while the absolute rate of recurrent events is variable, available evidence does not support an increased relative risk of recurrent ischemic events in those with vs without a patent foramen ovale. Patent foramen ovale closure in these patients cannot be recommended until the results of ongoing clinical trials are reported. |
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Authors:
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M A Almekhlafi; S B Wilton; D M Rabi; W A Ghali; D L Lorenzetti; M D Hill |
Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review Date: 2009-05-13 |
Journal Detail:
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Title: Neurology Volume: 73 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-14 Completed Date: 2009-08-07 Revised Date: 2011-09-02 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 89-97 Citation Subset: AIM; IM |
Affiliation:
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Room 1242A, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB, T2N 2T9 Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Brain Ischemia / epidemiology*, etiology*, mortality, therapy Foramen Ovale, Patent / complications*, epidemiology, mortality, therapy Humans Ischemic Attack, Transient / epidemiology, etiology, mortality, therapy Recurrence Risk Stroke / epidemiology*, etiology*, mortality, therapy Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Neurology. 2011 Jul 19;77(3):301-2; author reply 302
[PMID:
21768601
]
Neurology. 2009 Jul 14;73(2):84-5 [PMID: 19439718 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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