Pooled Analysis of PFO Occluder Device Trials in Patients With PFO and Migraine

Mojadidi, Mohammad K.; Kumar, Preetham; Mahmoud, Ahmed N.; Elgendy, Islam Y.; Shapiro, Hilary; West, Brian; Charles, Andrew; Mattle, Heinrich; Sorensen, Sherman G.; Meier, Bernhard; Silberstein, Stephen D.; Tobis, Jonathan M.

doi:10.1016/j.jacc.2020.11.068

Cited by 64 publications

(54 citation statements)

References 30 publications

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“…After removing the duplicates and irrelevant articles, 1009 full-text articles were eligible for further evaluation. Again, after reading the titles, abstracts, and the full text, 891 articles were eliminated, and we were left with 12 articles [7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Eventually, three randomized controlled trials and eight retrospective case series with 1165 participants were included for quantitative Nine procedure-related adverse events (access-site hematoma and transient hypotension) and 4 device-related adverse events (paroxysmal atrial fibrillation) synthesis.…”

Section: Resultsmentioning

confidence: 99%

“…To date, most single-center observations showed that PFO closure can effectively prevent migraine attacks, while three large randomized controlled trials (RCTs), MIST, PRIMA, and PREMIUM, have all reported negative results [9][10][11]. However, the latest study by Mohammad demonstrates that PFO closure was safe and significantly reduced the mean number of monthly migraine days and attacks, resulting in a greater number of subjects who experienced complete migraine cessation [12]. erefore, the therapeutic effects of this surgical procedure remain controversial.…”

Section: Introductionmentioning

confidence: 99%

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Patent Foramen Ovale Closure for Treating Migraine: A Meta-Analysis

Zhang

Wang

Liu

2022

Journal of Interventional Cardiology

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Background. Observational studies have shown percutaneous patent foramen ovale (PFO) closure to be a safe means of reducing the frequency and duration of migraine. Objective. This study evaluated the efficacy and safety of PFO closure in patients with migraine using evidence-based medicine. Methods. The Pubmed (MEDLINE), Embase, and Cochrane Library databases were searched for randomized controlled trials (RCTs), cohort studies, and retrospective case series from January 1, 2001, to February 30, 2021. The Jadad scale and R 4.1.0 software were used to assess the quality of the literature and meta-analysis, respectively. Results. In total, three randomized controlled trials, one pooled study, and eight retrospective case series including 1,165 participants were included in the meta-analysis. Compared with control intervention in migraine, PFO closure could significantly reduce headache frequency (OR = 1.5698, 95% CI: 1.0465–2.3548, p = 0.0293 ) and monthly migraine attacks and monthly migraine days (OR = 0.2594, 95% CI: 0.0790–0.4398, p = 0.0048 ). Subgroup analysis of patients who all completed PFO surgery showed resolution of migraine headache for migraines with aura (OR = 1.5856, 95% CI: 1.0665–2.3575, p = 0.0227 ). Conclusions. Treatment with PFO closure could reduce the frequency of headaches and monthly migraine days and is an efficient treatment for migraine attacks with aura.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patent Foramen Ovale Closure for Treating Migraine: A Meta-Analysis

Zhang

Wang

Liu

2022

Journal of Interventional Cardiology

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“…Previous reports showed an association between ischemic stroke and PFO because of paradoxical venous thromboembolism [ 32 – 35 ]. In addition, recent analyses have focused on stroke, TIA, or migraine [ 9 , 10 , 14 – 19 , 31 , 32 , 36 – 41 ]. The data showed that besides cryptogenic stroke, paradoxical embolism, and migraine, PFO can result in dizziness, syncope, chest tightness, and palpitations.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, presence of atrial septal herniation with PFO is a risk factor for cerebral infarction [ 2 – 4 , 8 – 13 ]. Therefore, many studies have analyzed the role of PFO on stroke and migraine [ 10 , 14 – 19 ]. However, PFO can also lead to other symptoms which include dizziness, syncope, chest tightness, and palpitations [ 20 – 28 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Patent Foramen Ovale: Analysis from a Single Center

Zhang

Song

et al. 2022

Cardiology Research and Practice

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Objective. To collect and analyze data of patent foramen ovale (PFO). Methods. This study included a total of 260 patients diagnosed with PFO. We analyzed basic clinical data such as sex, age, transesophageal echocardiography as well as other symptoms. Results. Our data showed that females accounted for the highest proportion of PFO (166 females, 64%), with the highest number of patients (65 patients) having between 45 and 55 years. Transesophageal echocardiography examination demonstrated frequent occurrence of tunnel-like anatomical structures. In addition, PFO was associated with symptoms such as migraine, stroke or TIA, syncope, chest tightness, and palpitations, with dizziness being the most common symptom in the patients with PFO. Conclusion. Our data demonstrated that females accounted for the highest proportion of PFO patients, with those aged between 45 and 55 years being most affected. The most frequently encountered clinical symptom was dizziness. Taken together, these findings may help doctors to better understand and screen for PFO patients.

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“…The importance of paradoxical emboli through a patent foramen ovale as a potential cause of ischaemic stroke or long‐term heart rhythm monitoring was not recognized yet at the time of the ARIC study. Therefore, many strokes related to paroxysmal atrial fibrillation or patent foramen ovale may have been missed in the ARIC study [41].…”

Section: Discussionmentioning

confidence: 99%

Migraine and atrial fibrillation: a systematic review

Scutelnic

Mattle

Branca

et al. 2021

Euro J of Neurology

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Background and purpose Patients with migraine are at increased risk of stroke. The aim was to systematically review the current literature on the association between migraine and atrial fibrillation, which is a relevant risk factor for stroke. Methods PubMed was searched for ‘migraine’ AND ‘atrial fibrillation’ and selected original investigations on the association of migraine and atrial fibrillation for our analysis. Articles without original data, such as guidelines, narrative reviews, editorials and others, were excluded. Results In all, 109 publications were found. Twenty‐two were included and analysed for this review. The population‐based Atherosclerosis Risk in Communities study showed a significant association of migraine with visual aura and incident atrial fibrillation (hazard ratio 1.30, 95% confidence interval 1.03–1.62, p = 0.02), but not for migraine without aura, compared to non‐headache persons after multivariable adjustment for vascular risk factors. An even larger population‐based study in Denmark confirmed this association (odds ratio 1.25, 95% confidence interval 1.16–1.36). Studies investigating patients with ischaemic stroke and migraine are methodologically insufficient and provide contradictory results. Ablation therapy for atrial fibrillation in patients with migraine might reduce migraine attacks, but transient post‐ablation new‐onset migraine‐like headaches in persons without a history of migraine have also been reported. Conclusion Population‐based studies indicate a significant association of migraine with aura and atrial fibrillation. In practical terms, screening for atrial fibrillation in patients who have a long history of migraine might be reasonable, whereas in patients with stroke or other disorders and migraine extensive screening for atrial fibrillation should be performed as in all patients without migraine.

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Pooled Analysis of PFO Occluder Device Trials in Patients With PFO and Migraine

Cited by 64 publications

References 30 publications

Patent Foramen Ovale Closure for Treating Migraine: A Meta-Analysis

Patent Foramen Ovale Closure for Treating Migraine: A Meta-Analysis

Characteristics of Patent Foramen Ovale: Analysis from a Single Center

Migraine and atrial fibrillation: a systematic review

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