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Received: 13 February 2018 Revised: 24 April 2018 Accepted: 30 April 2018 DOI: 10.1111/cns.12980
M E TA - A N A LY S I S
Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta-analysis of 5 randomized controlled trials and 14 observational studies Xi Chen
| Shi-Dong Chen | Yi Dong
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| Qiang Dong
Summary Background: Previous review from randomized controlled trials (RCT) showed that
Correspondence Qiang Dong, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China. Email:
[email protected]
patients with cryptogenic stroke may benefit from patent foramen ovale (PFO) closure. However, the findings from the systematic review were not clear when observational studies were also included. Methods: We searched MEDLINE, Embase, and Cochrane databases. The primary endpoints were recurrent stroke or transient ischemic attack (TIA). The secondary
Funding information Dr. Yi Dong is funded by Shanghai Excellent Young Specialist Training Program and China Science and Technology Association Young Talent Lifting Program.
outcomes were all-cause death, atrial fibrillation (AF), and hemorrhagic events. Results: Five randomized trials and fourteen observational studies (6301 participants) were eligible. PFO closure was superior to medical therapy for stroke prevention risk ratios ([RR], 0.38; 95% CI, 0.24-0.60), but showed increased risk of AF (RR, 4.96; 95% CI, 2.31-10.7). There was no significant difference in TIA recurrence, death, and hemorrhagic events. Subgroup analyses showed that patients with factors such as substantial residual shunt, the presence of atrial septal aneurysm (ASA), male, and age
