Valvular & structural heart disease
Standardized Mortality Ratio and Long-Term Stroke Incidence After Patent Foramen Ovale (PFO) Closure: A Register Study
Authors' conclusion
Patients undergoing PFO closure demonstrated a lower all-cause mortality compared to the general population. The observed rate of subsequent ischemic stroke was consistent with findings from previous randomized controlled trials. New-onset atrial fibrillation following PFO closure and active/previous smoking emerged as modifiable risk factors.
Study context
- Population
- Patients who underwent PFO closure, 2001–2018, national registers on congenital heart disease and stroke
- Participants
- 827 patients
- Outcome
- SMR, subsequent stroke and associated risk factors after PFO closure
- Follow-up
- Median 8.0 years (IQR: 4.8-11.0)
Methodological detailsnational register linkage
- National register linkage
Main finding
As reported in the abstract
Deaths during follow-up
23
Standardized mortality ratio (SMR)
0.65
all-cause mortality vs general population; 95% CI 0.41–0.98
Ischemic strokes
34
Ischemic stroke incidence rate
0.51 events per 100 patient-years
Observational data: associations, not effects.
Further findings
Risk factors for subsequent ischemic stroke
| HR (95% CI) | ||
|---|---|---|
| New-onset atrial fibrillation following PFO closure | 8.2 (2.6–25.8) | |
| Active/previous smoking | 2.5 (1.2–5.1) | |
| 0.050.21520Hazard ratio (log scale) |
Subsequent ischemic stroke · median follow-up 8.0 years
- Ischemic strokes
- 34
- Incidence rate
- 0.51 events per 100 patient-years
- Receiving antithrombotic therapy at time of stroke (of 34)
- 27
Original publication
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