Device Closure or Antithrombotic Therapy After Cryptogenic Stroke in Elderly Patients With a High-Risk Patent Foramen Ovaleopen access
- Authors
- Lee, Pil Hyung; Kim, Jung-Sun; Song, Jae-Kwan; Kwon, Sun U; Kim, Bum Joon; Lee, Ji Sung; Sun, Byung Joo; Woo, Jong Shin; Ann, Soe Hee; Suh, Jung-Won; Kim, Jun Yup; Lee, Kyusup; Lee, Sang Yeub; Heo, Ran; Jeong, Soo; Jang, Jeong Yoon; Bae, Jang-Whan; Kim, Young Dae; Heo, Sung Hyuk; Kim, Jong S
- Issue Date
- May-2024
- Publisher
- Korean Stroke Society
- Keywords
- Cryptogenic stroke; Device closure; Elderly patients; Patent foramen ovale; Stroke prevention
- Citation
- Journal of stroke, v.26, no.2, pp 242 - 251
- Pages
- 10
- Journal Title
- Journal of stroke
- Volume
- 26
- Number
- 2
- Start Page
- 242
- End Page
- 251
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74282
- DOI
- 10.5853/jos.2023.03265
- ISSN
- 2287-6391
2287-6405
- Abstract
- OBJECTIVE: In young patients (aged 18-60 years) with patent foramen ovale (PFO)-associated stroke, percutaneous closure has been found to be useful for preventing recurrent ischemic stroke or transient ischemic attack (TIA). However, it remains unknown whether PFO closure is also beneficial in older patients. METHODS: Patients aged ≥60 years who had a cryptogenic stroke and PFO from ten hospitals in South Korea were included. The effect of PFO closure plus medical therapy over medical therapy alone was assessed by a propensity-score matching method in the overall cohort and in those with a high-risk PFO, characterized by the presence of an atrial septal aneurysm or a large shunt. RESULTS: Out of the 437 patients (mean age, 68.1), 303 (69%) had a high-risk PFO and 161 (37%) patients underwent PFO closure. Over a median follow-up of 3.9 years, recurrent ischemic stroke or TIA developed in 64 (14.6%) patients. In the propensity score-matched cohort of the overall patients (130 pairs), PFO closure was associated with a significantly lower risk of a composite of ischemic stroke or TIA (hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.24-0.84; P=0.012), but not for ischemic stroke. In a subgroup analysis of confined to the high-risk PFO patients (116 pairs), PFO closure was associated with significantly lower risks of both the composite of ischemic stroke or TIA (HR: 0.40; 95% CI: 0.21-0.77; P=0.006) and ischemic stroke (HR: 0.47; 95% CI: 0.23-0.95; P=0.035). CONCLUSIONS: Elderly patients with cryptogenic stroke and PFO have a high recurrence rate of ischemic stroke or TIA, which may be significantly reduced by device closure.
- Files in This Item
-
- Appears in
Collections - ETC > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74282)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.