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Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population

PURPOSE: To compare the effectiveness of device closure and medical therapy in prevention of recurrent embolic event in the Korean population with cryptogenic stroke and patent foramen ovale (PFO). MATERIALS AND METHODS: Consecutive 164 patients (men: 126 patients, mean age: 48.1 years, closure grou...

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Autores principales: Moon, Jeonggeun, Kang, Woong Chol, Kim, Sihoon, Oh, Pyung Chun, Park, Yae Min, Chung, Wook-Jin, Choi, Deok Young, Lee, Ji Yeon, Lee, Yeong-Bae, Hwang, Hee Young, Ahn, Taehoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800350/
https://www.ncbi.nlm.nih.gov/pubmed/26996560
http://dx.doi.org/10.3349/ymj.2016.57.3.621
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author Moon, Jeonggeun
Kang, Woong Chol
Kim, Sihoon
Oh, Pyung Chun
Park, Yae Min
Chung, Wook-Jin
Choi, Deok Young
Lee, Ji Yeon
Lee, Yeong-Bae
Hwang, Hee Young
Ahn, Taehoon
author_facet Moon, Jeonggeun
Kang, Woong Chol
Kim, Sihoon
Oh, Pyung Chun
Park, Yae Min
Chung, Wook-Jin
Choi, Deok Young
Lee, Ji Yeon
Lee, Yeong-Bae
Hwang, Hee Young
Ahn, Taehoon
author_sort Moon, Jeonggeun
collection PubMed
description PURPOSE: To compare the effectiveness of device closure and medical therapy in prevention of recurrent embolic event in the Korean population with cryptogenic stroke and patent foramen ovale (PFO). MATERIALS AND METHODS: Consecutive 164 patients (men: 126 patients, mean age: 48.1 years, closure group: 72 patients, medical group: 92 patients) were enrolled. The primary end point was a composite of death, stroke, transient ischemic attack (TIA), or peripheral embolism. RESULTS: Baseline characteristics were similar in the two groups, except age, which was higher in the medical group (45.3±9.8 vs. 50.2±6.1, p<0.0001), and risk of paradoxical embolism score, which was higher in the closure group (6.2±1.6 vs. 5.7±1.3, p=0.026). On echocardiography, large right-to-left shunt (81.9% vs. 63.0%, p=0.009) and shunt at rest/septal hypermobility (61.1% vs. 23.9%, p<0.0001) were more common in the closure group. The device was successfully implanted in 71 (98.6%) patients. The primary end point occurred in 2 patients (2 TIA, 2.8%) in the closure group and in 2 (1 death, 1 stroke, 2.2%) in the medical group. Event-free survival rate did not differ between the two groups. CONCLUSION: Compared to medical therapy, device closure of PFO in patients with cryptogenic stroke did not show difference in reduction of recurrent embolic events in the real world's setting. However, considering high risk of echocardiographic findings in the closure group, further investigation of the role of PFO closure in the Asian population is needed.
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spelling pubmed-48003502016-05-01 Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population Moon, Jeonggeun Kang, Woong Chol Kim, Sihoon Oh, Pyung Chun Park, Yae Min Chung, Wook-Jin Choi, Deok Young Lee, Ji Yeon Lee, Yeong-Bae Hwang, Hee Young Ahn, Taehoon Yonsei Med J Original Article PURPOSE: To compare the effectiveness of device closure and medical therapy in prevention of recurrent embolic event in the Korean population with cryptogenic stroke and patent foramen ovale (PFO). MATERIALS AND METHODS: Consecutive 164 patients (men: 126 patients, mean age: 48.1 years, closure group: 72 patients, medical group: 92 patients) were enrolled. The primary end point was a composite of death, stroke, transient ischemic attack (TIA), or peripheral embolism. RESULTS: Baseline characteristics were similar in the two groups, except age, which was higher in the medical group (45.3±9.8 vs. 50.2±6.1, p<0.0001), and risk of paradoxical embolism score, which was higher in the closure group (6.2±1.6 vs. 5.7±1.3, p=0.026). On echocardiography, large right-to-left shunt (81.9% vs. 63.0%, p=0.009) and shunt at rest/septal hypermobility (61.1% vs. 23.9%, p<0.0001) were more common in the closure group. The device was successfully implanted in 71 (98.6%) patients. The primary end point occurred in 2 patients (2 TIA, 2.8%) in the closure group and in 2 (1 death, 1 stroke, 2.2%) in the medical group. Event-free survival rate did not differ between the two groups. CONCLUSION: Compared to medical therapy, device closure of PFO in patients with cryptogenic stroke did not show difference in reduction of recurrent embolic events in the real world's setting. However, considering high risk of echocardiographic findings in the closure group, further investigation of the role of PFO closure in the Asian population is needed. Yonsei University College of Medicine 2016-05-01 2016-03-15 /pmc/articles/PMC4800350/ /pubmed/26996560 http://dx.doi.org/10.3349/ymj.2016.57.3.621 Text en © Copyright: Yonsei University College of Medicine 2016 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Moon, Jeonggeun
Kang, Woong Chol
Kim, Sihoon
Oh, Pyung Chun
Park, Yae Min
Chung, Wook-Jin
Choi, Deok Young
Lee, Ji Yeon
Lee, Yeong-Bae
Hwang, Hee Young
Ahn, Taehoon
Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
title Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
title_full Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
title_fullStr Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
title_full_unstemmed Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
title_short Comparison of Outcomes after Device Closure and Medication Alone in Patients with Patent Foramen Ovale and Cryptogenic Stroke in Korean Population
title_sort comparison of outcomes after device closure and medication alone in patients with patent foramen ovale and cryptogenic stroke in korean population
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800350/
https://www.ncbi.nlm.nih.gov/pubmed/26996560
http://dx.doi.org/10.3349/ymj.2016.57.3.621
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