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Doubt Cast on Major Role for PFO Closure in Cryptogenic Stroke
Major Finding: Among patients with a recent history of cryptogenic stroke or transient ischemic attack and a patent foramen ovale, endovascular...
The researchers plan next to apply their new model for PFO-attributable stroke risk to the CLOSURE I data set. "We may be able to figure out why CLOSURE I didn’t work, and whether this approach could identify the patients who should have been in the trial" Dr. Thaler said. If the scoring method looks promising in the retrospective analysis, it might then be suitable for selecting patients to enroll into a new prospective study of PFO closure.
"The idea is that we’ll stratify patients in clinical studies, and – if all the stars align – we’ll be able to say that these are the patients who have the potential to benefit" from PFO closure, Dr. Kent said.
If these studies also find parameters that identify the types of PFOs that pose the greatest risk for causing strokes, the implications could extend beyond patients who already had a cryptogenic stroke.
"A quarter of the entire population has a PFO. Wouldn’t it be interesting if we could identify high-risk PFOs in the general population, among people who never had a stroke?" Dr. Thaler asked.
Dr. Kent said that he is a consultant to W.L. Gore & Associates. Dr. Thaler said that he is a consultant to W.L. Gore & Associates and AGA Medical.
*Correction, 3/12/2012: An earlier version of this article misstated the timing of the American Heart Association's annual scientific sessions at which the data were presented.
**Correction, 3/12/012: An earlier version of this article incorrectly stated that the study had already been published.