Propensity Score–Based Analysis of Percutaneous Closure Versus Medical Therapy in Patients With Cryptogenic Stroke and Patent Foramen Ovale: The IPSYS Registry (Italian Project on Stroke in Young Adults)

摘要: Background— We sought to compare the benefit of percutaneous closure that medical therapy alone for secondary prevention embolism in patients with patent foramen ovale (PFO) and otherwise unexplained ischemic stroke, a propensity scored study. Methods Results— Between 2000 2012, we selected consecutive first-ever stroke aged 18 45 years PFO no other cause brain ischemia, as part IPSYS registry (Italian Project on Stroke Young Adults), who underwent either or comparative analysis. Primary end point was composite transient attack, peripheral embolism. Secondary ischemia. Five hundred twenty-one qualified The primary occurred 15 treated (7.3%) versus 33 medically (10.5%; hazard ratio, 0.72; 95% confidence interval, 0.39–1.32; P =0.285). rates ischemia were also similar 2 treatment groups (6.3% group 10.2% group; 0.64; 0.33–1.21; =0.168). Closure provided 36 (hazard 0.19; 0.04–0.81; =0.026) those substantial right-to-left shunt size 0.05–0.68; =0.011). Conclusions— seems effective cryptogenic stroke. Whether device might be more cases, such younger than 37 size, deserves further investigation.