AI Article Synopsis
- A study compared the effectiveness of percutaneous PFO closure versus medical therapy for preventing further embolisms in young patients (ages 18 to 45) who had experienced unexplained ischemic strokes.
- Out of 521 patients analyzed, rates of subsequent strokes and brain ischemia were similar between both treatment groups, with PFO closure showing a slight advantage among younger patients and those with larger shunt sizes.
- The findings suggest that while PFO closure is comparable to medical treatment, it may be particularly beneficial for specific subgroups, warranting further research into targeted treatment strategies.
Article Abstract
Background: We sought to compare the benefit of percutaneous closure to that of medical therapy alone for the secondary prevention of embolism in patients with patent foramen ovale (PFO) and otherwise unexplained ischemic stroke, in a propensity scored study.
Methods And Results: Between 2000 and 2012, we selected consecutive first-ever ischemic stroke patients aged 18 to 45 years with PFO and no other cause of brain ischemia, as part of the IPSYS registry (Italian Project on Stroke in Young Adults), who underwent either percutaneous PFO closure or medical therapy for comparative analysis. Primary end point was a composite of ischemic stroke, transient ischemic attack, or peripheral embolism. Secondary end point was brain ischemia. Five hundred and twenty-one patients qualified for the analysis. The primary end point occurred in 15 patients treated with percutaneous PFO closure (7.3%) versus 33 patients medically treated (10.5%; hazard ratio, 0.72; 95% confidence interval, 0.39-1.32; P=0.285). The rates of the secondary end point brain ischemia were also similar in the 2 treatment groups (6.3% in the PFO closure group versus 10.2% in the medically treated group; hazard ratio, 0.64; 95% confidence interval, 0.33-1.21; P=0.168). Closure provided a benefit in patients aged 18 to 36 years (hazard ratio, 0.19; 95% confidence interval, 0.04-0.81; P=0.026) and in those with a substantial right-to-left shunt size (hazard ratio, 0.19; 95% confidence interval, 0.05-0.68; P=0.011).
Conclusions: PFO closure seems as effective as medical therapy for secondary prevention of cryptogenic ischemic stroke. Whether device treatment might be more effective in selected cases, such as in patients younger than 37 years and in those with a substantial right-to-left shunt size, deserves further investigation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/CIRCINTERVENTIONS.115.003470 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Adverse reactions associated with SSRIs and PD-1/PD-L1 inhibitors: a disproportionality analysis of the FDA adverse event reporting system.
Expert Opin Drug Saf
December 2024
Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: Selective serotonin reuptake inhibitors (SSRIs) are the primary choice for antidepressant therapy in cancer patients with depression. Programmed death-1 and programmed cell death-ligand 1 (PD-1/PD-L1) play a critical role in immune checkpoint inhibitors. To date, there have been no studies reporting adverse events (AEs) associated with the real-world use of PD-1/PD-L1 inhibitors-SSRIs combination.
View Article and Find Full Text PDFFenestrated and Branched Endovascular Aortic Repair and Mortality at Hospitals Without Investigational Device Trials.
JAMA Surg
December 2024
Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University, Baltimore, Maryland.
Importance: Fenestrated and branched endovascular aortic repairs (F/BEVAR) have been adopted by many centers. However, national trends of F/BEVAR use remain unclear, particularly at sites who perform them without an US Food and Drug Adminstration (FDA)-approved investigational device exemption (IDE).
Objective: To quantify the use of F/BEVAR in the US and to determine if mortality was different at IDE vs non-IDE sites.
A Multifunctional Ru-Re Complex for Photodynamic Therapy and CO-Mediated Therapeutics in Alzheimer's Disease.
Chemistry
December 2024
National Taiwan University Hospital, Immune Research Core, Department of Medical Research, TAIWAN.
The development of multifunctional therapeutic agents is crucial for addressing complex diseases such as Alzheimer's disease. Herein, we report a ruthenium-rhenium (Ru-Re) complex that combines photodynamic therapy (PDT) and carbon monoxide (CO) generation capabilities. The Ru-Re complex shows promising photophysical property and significant therapeutic potential.
View Article and Find Full Text PDFImmune Checkpoint Inhibitor-Induced Vitiligo-Like Depigmentation.
JAMA Dermatol
December 2024
Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France.
Home Visits and the Use of Routine and Emergency Postpartum Care Among Low-Income People: A Secondary Analysis of a Randomized Clinical Trial.
JAMA Netw Open
December 2024
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Importance: Access to appropriate postpartum care is essential for improving maternal health outcomes and promoting maternal health equity.
Objective: To analyze the impact of the Nurse-Family Partnership (NFP) home visiting program on use of routine and emergency postpartum care.
Design, Setting, And Participants: This study was a secondary analysis of a randomized clinical trial that enrolled eligible participants between 2016 and 2020 to receive NFP or usual care from a South Carolina Medicaid program.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!