Sustained risk of recurrent thromboembolic events in patients with patent foramen ovale and paradoxical embolism: long-term follow-up over more than 15 years

Fischer, Dieter; Gardiwal, Ajmal; Haentjes, Jonas; Klein, Gunnar; Meyer, G. P.; Drexler, Helmut; Hausmann, Dirk; Schaefer, Arnd

doi:10.1007/s00392-011-0392-2

Cited by 17 publications

(13 citation statements)

References 29 publications

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“…Evidence is conflicting regarding the role of atrial septal aneurysm, and there is little evidence that the size of the PFO defect affects stroke risk. 625,[629][630][631][632][633] Only 1 study 631 compared outcomes in patients with PFO and stroke randomized to either aspirin or warfarin. Among 630 patients in the Patent Foramen Ovale in Cryptogenic Stroke (PICSS) substudy of WARSS, the 2-year event rate of recurrent stroke or death was 16.5% in the warfarin-treated group and 13.2% in the aspirin-treated group (HR, 1.3; 95% CI, 0.6-2.6).…”

Section: Patent Foramen Ovalementioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

3,946

1,326

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The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

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Section: Patent Foramen Ovalementioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

3,946

1,326

View full text Add to dashboard Cite

show abstract

“…Recently, a study with a mean follow-up period of 15 years was published, in 86 patients, less than 75 years old at the time of enrolment. The recurrent risk of stroke was rather high -15% after a mean period of 4.9 years, reflecting a calculated event rate of 0.98% per year in this cohort [30]. The occurrence of stroke was not associated with differences in baseline data, the presence of atrial septal aneurysm, PFO size or chosen treatment (PFO closure, anticoagulation, antithrombotic therapy).…”

Section: Patent Foramen Ovale and Cryptogenic Strokementioning

confidence: 67%

“…Also, groups were relatively small. It seems important that patients with subsequent stroke have statistically significantly more multiple risk factors [30]. In another study of 280 patients with mean follow-up of 2.6 years, the recurrence rate was 0.6% per year for patients treated with interventional closure devices and 13% per year for medical treatment with acetylsalicylic acid [31].…”

Section: Patent Foramen Ovale and Cryptogenic Strokementioning

confidence: 99%

Patent foramen ovale: to close or not to close – still the question

Kumor¹

2012

pwki

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“…In a very recent paper, Fisher et al [54] studied the long-term risk of stroke recurrence in 86 patients with a PFO-related stroke. These patients constituted 89% of the original cohort.…”

Section: Epidemiology Of Ischemic Stroke In Young Adults With Pfomentioning

confidence: 99%

Stroke and Patent Foramen Ovale in Young Individuals

Piechowski-Jóźwiak

Bogousslavsky

2012

Eur Neurol

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The importance of patent foramen ovale (PFO) has long been discussed in the literature in relation to different coexisting medical conditions. Many researchers focused on the occurrence of PFO in ischemic stroke patients, especially in the subgroup of young patients with a recurrent event. Unfortunately, before establishing a clear significance of PFO and right-to-left shunting (RLS) in pathogenesis of cerebrovascular disorders, multiple interventional trials have been launched, aimed at PFO closure in heterogeneous populations of patients. Moreover, some closure devices were granted at least partial approval by regulatory agencies for this indication. There is a need for large and unbiased epidemiological studies assessing the role of RLS through the PFO in ischemic stroke. All patients with recurrent ischemic events and PFO should be assessed by multidisciplinary teams, including a stroke neurologist, and all potential and rare causes of stroke should be considered before any decision for closure is made.

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Sustained risk of recurrent thromboembolic events in patients with patent foramen ovale and paradoxical embolism: long-term follow-up over more than 15 years

Cited by 17 publications

References 29 publications

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Patent foramen ovale: to close or not to close – still the question

Stroke and Patent Foramen Ovale in Young Individuals

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