Recurrent stroke and patent foramen ovale: A systematic review and meta-analysis

Stroke

Volumn 45, Issue 11, 2014, Pages 3352-3359

  Katsanos, Aristeidis H ^a   Spence, J David ^b   Bogiatzi, Chrysi ^b   Parissis, John ^c   Giannopoulos, Sotirios ^a   Frogoudaki, Alexandra ^c   Safouris, Apostolos ^d   Voumvourakis, Konstantinos ^c   Tsivgoulis, Georgios ^c,e  

^a UNIVERSITY OF IOANNINA   (Greece)

^b ROBARTS RESEARCH INSTITUTE   (Canada)

^c UNIVERSITY OF ATHENS   (Greece)

^d BRUGMANN UNIVERSITY HOSPITAL   (Belgium)

^e ST ANNE S UNIVERSITY HOSPITAL   (Czech Republic)

Author keywords

Foramen ovale; Ischemic attack; Patent; Stroke; Transcranial Doppler ultrasonography; Transesophageal echocardiography; Transient

Indexed keywords

BIBLIOGRAPHIC DATABASE; BRAIN ISCHEMIA; CARDIOVASCULAR RISK; CEREBROVASCULAR ACCIDENT; ECHOGRAPHY; FOLLOW UP; HEART RIGHT LEFT SHUNT; HUMAN; META ANALYSIS; METHODOLOGY; PATENT FORAMEN OVALE; PRACTICE GUIDELINE; PRIORITY JOURNAL; RECURRENT DISEASE; REVIEW; STROKE PATIENT; SYSTEMATIC REVIEW; TRANSCRANIAL SONOGRAPHY; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; TRANSIENT ISCHEMIC ATTACK; FORAMEN OVALE, PATENT; PROSPECTIVE STUDY; RISK FACTOR; STROKE;

FORAMEN OVALE, PATENT; HUMANS; PROSPECTIVE STUDIES; RECURRENCE; RISK FACTORS; STROKE;

EID: 84922481308     PISSN: 00392499     EISSN: 15244628     Source Type: Journal    
DOI: 10.1161/STROKEAHA.114.007109     Document Type: Review

References (63)

1. Di Tullio MR. Patent foramen ovale: echocardiographic detection and clinical relevance in stroke. J Am Soc Echocardiogr. 2010;23:144-55, quiz 220.
2. Jumaa MA, Wechsler LR. Management of patent foramen ovale and stroke. Curr Treat Options Neurol. 2010;12:483-491.
3. Fischer D, Gardiwal A, Haentjes J, Klein G, Meyer GP, Drexler H, et al. Sustained risk of recurrent thromboembolic events in patients with patent foramen ovale and paradoxical embolism: long-term follow-up over more than 15 years. Clin Res Cardiol. 2012;101:297-303.
4. Alsheikh-Ali AA, Thaler DE, Kent DM. Patent foramen ovale in cryptogenic stroke: incidental or pathogenic? Stroke. 2009;40:2349-2355.
5. Mono ML, Geister L, Galimanis A, Jung S, Praz F, Arnold M, et al. Patent foramen ovale may be causal for the first stroke but unrelated to subsequent ischemic events. Stroke. 2011;42:2891-2895.
6. Thaler DE, Kent DM. Rethinking trial strategies for stroke and patent foramen ovale. Curr Opin Neurol. 2010;23:73-78.
7. Kent DM, Ruthazer R, Weimar C, Mas JL, Serena J, Homma S, et al. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology. 2013;81:619-625.
8. Thaler DE, Saver JL. Cryptogenic stroke and patent foramen ovale. Curr Opin Cardiol. 2008;23:537-544.
9. Natanzon A, Goldman ME. Patent foramen ovale: anatomy versus pathophysiology-which determines stroke risk? J Am Soc Echocardiogr. 2003;16:71-76.
10. Komar M, Podolec P, Przewłocki T, Wilkołek P, Tomkiewicz-Pająk L, Motyl R. Transoesophageal echocardiography can help distinguish between patients with "symptomatic" and "asymptomatic" patent foramen ovale. Kardiol Pol. 2012;70:1258-1263.
11. Telman G, Yalonetsky S, Kouperberg E, Sprecher E, Lorber A, Yarnitsky D. Size of PFO and amount of microembolic signals in patients with ischaemic stroke or TIA. Eur J Neurol. 2008;15:969-972.
12. Kobayashi K, Iguchi Y, Kimura K, Okada Y, Terasawa Y, Matsumoto N, et al. Contrast transcranial Doppler can diagnose large patent foramen ovale. Cerebrovasc Dis. 2009;27:230-234.
13. Akhondi A, Gevorgyan R, Tseng CH, Slavin L, Dao C, Liebeskind DS, et al. The association of patent foramen ovale morphology and stroke size in patients with paradoxical embolism. Circ Cardiovasc Interv. 2010;3:506-510.
14. Wessler BS, Thaler DE, Ruthazer R, Weimar C, Di Tullio MR, Elkind MS, et al. Transesophageal echocardiography in cryptogenic stroke and patent foramen ovale: analysis of putative high-risk features from the risk of paradoxical embolism database. Circ Cardiovasc Imaging. 2014;7:125-131.
15. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-e34.
16. Katsanos AH, Giannopoulos S, Kosmidou M, Voumvourakis K, Parissis JT, Kyritsis AP, et al. Complex atheromatous plaques in the descending aorta and the risk of stroke: a systematic review and meta-analysis. Stroke. 2014;45:1764-1770.
17. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al; Cochrane Bias Methods Group; Cochrane Statistical Methods Group. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
18. Sweeting MJ, Sutton AJ, Lambert PC. What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med. 2004;23:1351-1375.
19. Khan NR, Tsivgoulis G, Lee SL, Jones GM, Green CS, Katsanos AH, et al. Fibrinolysis for intraventricular hemorrhage: an updated meta-analysis and systematic review of the literature. Stroke. 2014;45:2662-2669.
20. Deeks JJ, Higgins JP, Altman DG. Chapter 9: Analysing data and undertaking meta-analyses. In: Cochrane Handbook for Systematic Reviews of Interventions. http://handbook.cochrane.org/chapter-9/9-analysing- data-and-undertaking-meta-analyses.htm. Updated March 2011. Accessed February 4, 2014.
21. Sterne JA, Egger M, Smith GD. Systematic reviews in health care: Investigating and dealing with publication and other biases in metaanalysis. BMJ. 2001;323:101-105.
22. Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54:1046-1055.
23. Deeks JJ, Higgins JP, Altman DG. Chapter 10.4.3.1: Recommendations on testing for funnel plot asymmetry. In: Cochrane Handbook for Systematic Reviews of Interventions. http://handbook.cochrane.org/ chapter-10/10-4-3-1-recommendations-on-testing-for-funnel-plot- asymmetry.htm. Updated March 2011. Accessed February 4, 2014.
24. Tobe J, Bogiatzi C, Munoz C, Tamayo A, Spence D. Transcranial Doppler is superior to TEE for the detection of patent foramen ovale. Stroke. 2014; 45(suppl 1):LB10.
25. Tsivgoulis G, Stamboulis E, Sharma VK, Heliopoulos I, Voumvourakis K, Teoh HL, et al. Safety of transcranial Doppler 'bubble study' for identification of right to left shunts: an international multicentre study. J Neurol Neurosurg Psychiatry. 2011;82:1206-1208.
26. Hanna JP, Sun JP, Furlan AJ, Stewart WJ, Sila CA, Tan M. Patent foramen ovale and brain infarct. Echocardiographic predictors, recurrence, and prevention. Stroke. 1994;25:782-786.
27. Schuchlenz HW, Weihs W, Berghold A, Lechner A, Schmidt R. Secondary prevention after cryptogenic cerebrovascular events in patients with patent foramen ovale. Int J Cardiol. 2005;101:77-82.
28. Weimar C, Holle DN, Benemann J, Schmid E, Schminke U, Haberl RL, et al; German Stroke Study Collaboration. Current management and risk of recurrent stroke in cerebrovascular patients with right-to-left cardiac shunt. Cerebrovasc Dis. 2009;28:349-356.
29. Paciaroni M, Agnelli G, Bertolini A, Pezzini A, Padovani A, Caso V, et al; FORI (Foramen Ovale Registro Italiano) Investigators. Risk of recurrent cerebrovascular events in patients with cryptogenic stroke or transient ischemic attack and patent foramen ovale: The FORI (Foramen Ovale Registro Italiano) study. Cerebrovasc Dis. 2011;31:109-116.
30. Casaubon L, McLaughlin P, Webb G, Yeo E, Merker D, Jaigobin C. Recurrent stroke/TIA in cryptogenic stroke patients with patent foramen ovale. Can J Neurol Sci. 2007;34:74-80.
31. Harrer JU, Wessels T, Franke A, Lucas S, Berlit P, Klotzsch C. Stroke recurrence and its prevention in patients with patent foramen ovale. Can J Neurol Sci. 2006;33:39-47.
32. Cerrato P, Priano L, Imperiale D, Bosco G, Destefanis E, Villar AM, et al. Recurrent cerebrovascular ischaemic events in patients with interatrial septal abnormalities: a follow-up study. Neurol Sci. 2006;26:411-418.
33. Homma S, Sacco RL, Di Tullio MR, Sciacca RR, Mohr JP; PFO in Cryptogenic Stroke Study (PICSS) Investigators. Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation. 2002;105:2625-2631.
34. Anzola GP, Zavarize P, Morandi E, Rozzini L, Parrinello G. Transcranial Doppler and risk of recurrence in patients with stroke and patent foramen ovale. Eur J Neurol. 2003;10:129-135.
35. Arauz A, Murillo L, Marquez JM, Tamayo A, Cantu C, Roldan FJ, et al. Long-term risk of recurrent stroke in young cryptogenic stroke patients with and without patent foramen ovale. Int J Stroke. 2012;7:631-634.
36. Furlan AJ, Reisman M, Massaro J, Mauri L, Adams H, Albers GW, et al; CLOSURE I Investigators. Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N Engl J Med. 2012;366:991-999.
37. Serena J, Marti-Fabregas J, Santamarina E, Rodriguez JJ, Perez-Ayuso MJ, Masjuan J, et al; CODICIA, Right-to-Left Shunt in Cryptogenic Stroke Study; Stroke Project of the Cerebrovascular Diseases Study Group, Spanish Society of Neurology. Recurrent stroke and massive right-to-left shunt: results from the prospective Spanish multicenter (CODICIA) study. Stroke. 2008;39:3131-3136.
38. Cujec B, Mainra R, Johnson DH. Prevention of recurrent cerebral ischemic events in patients with patent foramen ovale and cryptogenic strokes or transient ischemic attacks. Can J Cardiol. 1999;15:57-64.
39. De Castro S, Cartoni D, Fiorelli M, Rasura M, Anzini A, Zanette EM, et al. Morphological and functional characteristics of patent foramen ovale and their embolic implications. Stroke. 2000;31:2407-2413.
40. Di Legge S, Sallustio F, De Marchis E, Rossi C, Koch G, Diomedi M, et al. Short-term and two-year rate of recurrent cerebrovascular events in patients with acute cerebral ischemia of undetermined aetiology, with and without a patent foramen ovale. ISRN Neurol. 2011;2011:959483.
41. Feurer R, Sadikovic S, Sepp D, Esposito L, Schleef M, Bockelbrink A, et al. Patent foramen ovale is not associated with an increased risk of stroke recurrence. Eur J Neurol. 2010;17:1339-1345.
42. Fukuoka T, Dembo T, Nagoya H, Kato Y, Yasuko O, Deguchi I, et al. Factors related to recurrence of paradoxical cerebral embolism due to patent foramen ovale. J Neurol. 2012;259:1051-1055.
43. Homma S, DiTullio MR, Sacco RL, Sciacca RR, Mohr JP; PICSS Investigators. Age as a determinant of adverse events in medically treated cryptogenic stroke patients with patent foramen ovale. Stroke. 2004;35:2145-2149.
44. Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G, et al; Patent Foramen Ovale and Atrial Septal Aneurysm Study Group. Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N Engl J Med. 2001;345:1740-1746.
45. Carroll JD, Saver JL, Thaler DE, Smalling RW, Berry S, MacDonald LA, et al; RESPECT Investigators. Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. N Engl J Med. 2013;368:1092-1100.
46. Kitsios GD, Dahabreh IJ, Abu Dabrh AM, Thaler DE, Kent DM. Patent foramen ovale closure and medical treatments for secondary stroke prevention: a systematic review of observational and randomized evidence. Stroke. 2012;43:422-431.
47. Khan AR, Bin Abdulhak AA, Sheikh MA, Khan S, Erwin PJ, Tleyjeh I, et al. Device closure of patent foramen ovale versus medical therapy in cryptogenic stroke: a systematic review and meta-analysis. JACC Cardiovasc Interv. 2013;6:1316-1323.
48. Spencer FA, Lopes LC, Kennedy SA, Guyatt G. Systematic review of percutaneous closure versus medical therapy in patients with cryptogenic stroke and patent foramen ovale. BMJ Open. 2014;4:e004282.
49. Udell JA, Opotowsky AR, Khairy P, Silversides CK, Gladstone DJ, O'Gara PT, et al. Patent foramen ovale closure vs medical therapy for stroke prevention: meta-analysis of randomized trials and review of heterogeneity in meta-analyses. Can J Cardiol. 2014;30:1216-1224.
50. Almekhlafi MA, Wilton SB, Rabi DM, Ghali WA, Lorenzetti DL, Hill MD. Recurrent cerebral ischemia in medically treated patent foramen ovale: a meta-analysis. Neurology. 2009;73:89-97.
51. Ma B, Liu G, Chen X, Zhang J, Liu Y, Shi J. Risk of stroke in patients with patent foramen ovale: an updated meta-analysis of observational studies. J Stroke Cerebrovasc Dis. 2014;23:1207-1215.
52. Meissner I, Khandheria BK, Heit JA, Petty GW, Sheps SG, Schwartz GL, et al. Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study. J Am Coll Cardiol. 2006;47:440-445.
53. Di Tullio MR, Sacco RL, Sciacca RR, Jin Z, Homma S. Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. J Am Coll Cardiol. 2007;49:797-802.
54. Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160-2236.
55. Mojadidi MK, Bogush N, Caceres JD, Msaouel P, Tobis JM. Diagnostic accuracy of transesophageal echocardiogram for the detection of patent foramen ovale: a meta-analysis. Echocardiography. 2014;31:752-758.
56. Mojadidi MK, Winoker JS, Roberts SC, Msaouel P, Zaman MO, Gevorgyan R, et al. Accuracy of conventional transthoracic echocardiography for the diagnosis of intracardiac right-to-left shunt: a meta-analysis of prospective studies. Echocardiography. 2014;31:1036-1048.
57. Nygren AT, Jogestrand T. Detection of patent foramen ovale by transcranial Doppler and carotid duplex ultrasonography: a comparison with transoesophageal echocardiography. Clin Physiol. 1998;18:327-330.
58. Van H, Poommipanit P, Shalaby M, Gevorgyan R, Tseng CH, Tobis J. Sensitivity of transcranial Doppler versus intracardiac echocardiography in the detection of right-to-left shunt. JACC Cardiovasc Imaging. 2010;3:343-348.
59. Pristipino C, Anzola GP, Ballerini L, Bartorelli A, Cecconi M, Chessa M, et al; Italian Society of Invasive Cardiology (SICI-GISE); Italian Stroke Association (ISA-AIS); Italian Association of Hospital Neurologists, Neuroradiologists, Neurosurgeons (SNO); Congenital Heart Disease Study Group of Italian Society Of Cardiology; Italian Association Of Hospital Cardiologists (ANMCO); Italian Society Of Pediatric Cardiology (SICP); Italian Society of Cardiovascular Echography (SIEC); Italian Society of Hemostasis and Thrombosis (SISET). Management of patients with patent foramen ovale and cryptogenic stroke: a collaborative, multidisciplinary, position paper: executive summary. Catheter Cardiovasc Interv. 2013;82:122-129.
60. Rundek T. PFO in stroke: a direct association or coincidence? Eur J Neurol. 2008;15:887-888.
61. Caputi L, Carriero MR, Falcone C, Parati E, Piotti P, Materazzo C, et al. Transcranial Doppler and transesophageal echocardiography: comparison of both techniques and prospective clinical relevance of transcranial Doppler in patent foramen ovale detection. J Stroke Cerebrovasc Dis. 2009;18:343-348.
62. Dahabreh IJ, Kent DM. Index event bias as an explanation for the paradoxes of recurrence risk research. JAMA. 2011;305:822-823.
63. Goel SS, Tuzcu EM, Shishehbor MH, de Oliveira EI, Borek PP, Krasuski RA, et al. Morphology of the patent foramen ovale in asymptomatic versus symptomatic (stroke or transient ischemic attack) patients. Am J Cardiol. 2009;103:124-129.