Document Detail


Secondary prevention of cerebral ischemia in patent foramen ovale: systematic review and meta-analysis.
MedLine Citation:
PMID:  11531177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Therapy for patent foramen ovale (PFO), found with increased frequency in the setting of stroke in the young, is controversial. We compiled a synthesis of the literature on therapeutic options for PFO and stroke. METHODS: Searching MEDLINE (1966 to 1999), published abstracts, and bibliographies of primary and review articles, we identified five retrospective cohort studies that compared at least two different treatment options (antiplatelet therapy, warfarin, or surgery). Outcomes data on mode of therapy and recurrent stroke were abstracted, and pooled analysis was done using a random effects model. RESULTS: Warfarin was superior to antiplatelet therapy in preventing recurrent ischemic events (odds ratio [OR] 0.37; 95% confidence interval [CI], 0.23 to 0.60). Surgical PFO closure was comparable to warfarin treatment (OR 1.19; 95% CI, 0.62 to 2.27). CONCLUSION: Available data suggest that warfarin is superior to antiplatelet therapy and comparable to surgical PFO closure for the prevention of recurrent cerebral ischemic events from paradoxical embolism.
Authors:
M A Orgera; P G O'Malley; A J Taylor
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Southern medical journal     Volume:  94     ISSN:  0038-4348     ISO Abbreviation:  South. Med. J.     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-09-03     Completed Date:  2001-09-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  699-703     Citation Subset:  AIM; IM    
Affiliation:
Cardiology and General Internal Medicine Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / therapeutic use*
Brain Ischemia* / etiology,  prevention & control
Heart Septal Defects, Atrial / complications*
Humans
Male
Middle Aged
Warfarin / therapeutic use*
Chemical
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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