Updated Meta-analysis on the Closure of Patent Foramen Ovale in Reduction of Stroke Rates: the DEFENSE-PFO Trial Does not Change the Scenario
Fuente:
Redalyc
Saved in:
| Main Author: | |
|---|---|
| Format: | Artículo científico |
| Language: | en |
| Published: |
Sociedade Brasileira de Cirurgia Cardiovascular
2018
|
| Subjects: | |
| Online Access: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1876426479918645248 |
|---|---|
| author | Michel Pompeu Barros Oliveira Sá |
| author_facet | Michel Pompeu Barros Oliveira Sá |
| contents | Updated Meta-analysis on the Closure of Patent Foramen Ovale in Reduction of Stroke Rates: the DEFENSE-PFO Trial Does not Change the Scenario Michel Pompeu Barros Oliveira Sá Erik Everton Silva Vieira Luiz Rafael Pereira Cavalcanti Roberto Gouveia Silva Diniz Sérgio da Costa Rayol Alexandre Motta de Menezes Ricardo Felipe de Albuquerque Lins Ricardo Carvalho Lima Medicina Meta Patent analysis Foramen Ovale Vascular Closure Devices Objective: We aimed to analyze whether patent foramen ovale (PFO) closure reduces the risk of stroke, assessing also some safety outcomes after the publication of a new trial. Introduction: The clinical benefit of closing a PFO has been an open question, so it is necessary to review the current state of published medical data in regards to this subject. Methods: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were used to search for randomized controlled trials (RCTs) that reported any of the following outcomes: stroke, death, major bleeding or atrial fibrillation. Six studies fulfilled our eligibility criteria and included 3560 patients (1889 for PFO closure and 1671 for medical therapy. Results: The risk ration (RR) for stroke in the “closure” group compared with the “medical therapy” showed a statistically significant difference between the groups, favouring the “closure” group (RR 0.366; 95%CI 0.171–0.782, P=0.010). There was no statistically significant difference between the groups regarding the safety outcomes, death and major bleeding, but we observed an increase in the risk of atrial fibrillation in the “closure” group (RR 4.131; 95%CI 2.293–7.443, P<0.001). We also observed that the larger the proportion of effective closure, the lower the risk of stroke. Conclusion: This meta-analysis found that stroke rates are lower with percutaneously implanted device closure than with medical therapy alone, being these rates modulated by the rates of hypertension, atrial septal aneurysm and effective closure. The publication of a new trial did not change the scenario in the medical literature. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398957528014 https://www.redalyc.org/journal/3989/398957528014/ https://www.redalyc.org/journal/3989/398957528014/html/ https://www.redalyc.org/journal/3989/398957528014/398957528014.epub https://www.redalyc.org/journal/3989/398957528014/movil 10.21470/1678-9741-2018-0194 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.5 Vol.33 |
| format | Artículo científico |
| id | redalyc_398957528014 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Updated Meta-analysis on the Closure of Patent Foramen Ovale in Reduction of Stroke Rates: the DEFENSE-PFO Trial Does not Change the Scenario Michel Pompeu Barros Oliveira Sá Medicina Meta Patent analysis Foramen Ovale Vascular Closure Devices Updated Meta-analysis on the Closure of Patent Foramen Ovale in Reduction of Stroke Rates: the DEFENSE-PFO Trial Does not Change the Scenario Michel Pompeu Barros Oliveira Sá Erik Everton Silva Vieira Luiz Rafael Pereira Cavalcanti Roberto Gouveia Silva Diniz Sérgio da Costa Rayol Alexandre Motta de Menezes Ricardo Felipe de Albuquerque Lins Ricardo Carvalho Lima Medicina Meta Patent analysis Foramen Ovale Vascular Closure Devices Objective: We aimed to analyze whether patent foramen ovale (PFO) closure reduces the risk of stroke, assessing also some safety outcomes after the publication of a new trial. Introduction: The clinical benefit of closing a PFO has been an open question, so it is necessary to review the current state of published medical data in regards to this subject. Methods: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were used to search for randomized controlled trials (RCTs) that reported any of the following outcomes: stroke, death, major bleeding or atrial fibrillation. Six studies fulfilled our eligibility criteria and included 3560 patients (1889 for PFO closure and 1671 for medical therapy. Results: The risk ration (RR) for stroke in the “closure” group compared with the “medical therapy” showed a statistically significant difference between the groups, favouring the “closure” group (RR 0.366; 95%CI 0.171–0.782, P=0.010). There was no statistically significant difference between the groups regarding the safety outcomes, death and major bleeding, but we observed an increase in the risk of atrial fibrillation in the “closure” group (RR 4.131; 95%CI 2.293–7.443, P<0.001). We also observed that the larger the proportion of effective closure, the lower the risk of stroke. Conclusion: This meta-analysis found that stroke rates are lower with percutaneously implanted device closure than with medical therapy alone, being these rates modulated by the rates of hypertension, atrial septal aneurysm and effective closure. The publication of a new trial did not change the scenario in the medical literature. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398957528014 https://www.redalyc.org/journal/3989/398957528014/ https://www.redalyc.org/journal/3989/398957528014/html/ https://www.redalyc.org/journal/3989/398957528014/398957528014.epub https://www.redalyc.org/journal/3989/398957528014/movil 10.21470/1678-9741-2018-0194 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.5 Vol.33 |
| title | Updated Meta-analysis on the Closure of Patent Foramen Ovale in Reduction of Stroke Rates: the DEFENSE-PFO Trial Does not Change the Scenario |
| topic | Medicina Meta Patent analysis Foramen Ovale Vascular Closure Devices |
| url | https://www.redalyc.org/articulo.oa?id=398957528014 https://www.redalyc.org/journal/3989/398957528014/ https://www.redalyc.org/journal/3989/398957528014/html/ https://www.redalyc.org/journal/3989/398957528014/398957528014.epub https://www.redalyc.org/journal/3989/398957528014/movil |