Letter by Mojadidi et al Regarding Article, “Closure of Patent Foramen Ovale Versus Medical Therapy in Patients With Cryptogenic Stroke or Transient Ischemic Attack: Updated Systematic Review and Meta-Analysis”
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To the Editor:
We read with interest the recent article by Ntaios et al.1 In a meta-analysis of randomized trials, the authors reported the efficacy and safety of transcatheter patent foramen ovale (PFO) closure for prevention of recurrent stroke, in patients with an index cryptogenic stroke/transient ischemic attack. Among 3627 patients (5 trials), there was a significantly lower rate of recurrent stroke in patients randomized to a PFO-occluding device compared with medical therapy (0.53 versus 1.1 per 100 patient-years; odds ratio, 0.43; 95% confidence interval, 0.21–0.90) at a mean follow-up of 3.7 years. In the discussion, the authors mention the important role of non-vitamin K antagonists in the prevention of venous thromboembolism, given venous thromboembolism seems to be the main issue in PFO-mediated stroke. …