Patent foramen ovale is a significant risk factor for patients with coronary artery disease: a long-term follow-up study
Authors' conclusion
PFO is associated with adverse prognosis in patients with CAD, and patients with PFO have a higher risk of MACEs.
Study context
- Population
- Patients who underwent coronary computed tomography angiography (CCTA) for the evaluation of suspected coronary artery disease (CAD)
- Participants
- 2,667 patients
- Exposure
- Patients with patent foramen ovale (PFO) compared with patients without PFO
- Outcome
- Composite of:
- Cardiac death
- Non-fatal myocardial infarction
- Follow-up
- Median 86 months (interquartile range: 74-99 months)
Methodological detailsretrospective
- Retrospective
Main finding
As reported in the abstract
- Patients who had the primary endpoint (among those with major adverse cardiovascular events (MACEs))
- 203
- Higher cumulative incidence with PFO
- P < 0.001
- PFO independent predictor in multivariate analysis (primary and secondary endpoints)
- All P < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR | P value |
|---|---|---|
| MACEs (cardiac death, non-fatal myocardial infarction, and ischemic stroke) · median follow-up of 86 months (interquartile range: 74-99 months)Patients with PFO vs patients without PFO | 3.82 | P < 0.001 |
| MACEs (cardiac death, non-fatal myocardial infarction, and ischemic stroke) · median follow-up of 86 months (interquartile range: 74-99 months)Patients with PFO vs patients without PFO · multivariate analysis | 2.98 | P < 0.001 |
- MACEs (cardiac death, non-fatal myocardial infarction, and ischemic stroke) — Patients who experienced MACEs
- 288
- MACEs (cardiac death, non-fatal myocardial infarction, and ischemic stroke) — Higher cumulative incidence of MACEs with PFO
- P < 0.001
Ischemic stroke (secondary endpoint)
- Patients who had the secondary endpoint (among those with MACEs)
- 85
- Higher cumulative incidence with PFO
- P < 0.001
Original publication
Patent foramen ovale is a significant risk factor for patients with coronary artery disease: a long-term follow-up study. Eur Heart J Cardiovasc Imaging. Published 8 December 2025. doi:10.
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