Risk of stroke in patients with patent foramen ovale: an updated meta-analysis of observational studies

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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence

Published on: December 23, 2022

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Bing Ma1, Guangcong Liu2, Xin Chen1

  • 1Department of Clinical Epidemiology, and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|February 6, 2014
PubMed

Insights

Patent foramen ovale (PFO) may be linked to cryptogenic stroke (CS), but observational data show conflicting results. Case-control studies suggest a strong association, while cohort studies do not, indicating more research is needed.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Research

Background:

  • Patent foramen ovale (PFO) is a debated risk factor for cryptogenic stroke (CS).
  • Previous randomized controlled trials have yielded inconsistent results regarding the PFO-stroke association.
  • Observational data are re-evaluated to clarify the relationship between PFO and stroke.

Purpose of the Study:

  • To reassess the association between PFO and stroke using observational studies.
  • To synthesize evidence from case-control and cohort studies via meta-analysis.
  • To investigate factors influencing the observed association.

Main Methods:

  • Systematic electronic search of PubMed, Web of Science, and CNKI databases.
  • Inclusion of case-control and cohort studies in English or Chinese.
  • Random-effects meta-analysis to assess the PFO-stroke link.

Main Results:

  • Case-control studies indicated a significant association between PFO and CS (OR: 2.94).
  • Cohort studies did not demonstrate a significant association (HR: 1.28).
  • Subgroup analyses showed varied results based on region, confounder adjustment, study quality, and diagnostic methods.

Conclusions:

  • While case-control studies suggest a positive PFO-stroke effect, cohort study results challenge this.
  • The credibility of PFO as a cause of stroke remains uncertain.
  • Further clinical trial data are required to definitively confirm the effect of PFO on stroke.
Abstract

Keywords:
PFOStrokemeta-analysisobservational studies

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