Cochrane · systematic review · CD009938
Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
Li, J, Liu, J, Liu, M, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
StrokeAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
11
No studies
1
Included studies
NR
No studies 1 · 8.3%Ungraded 0 · 0%Very low 0 · 0%Low 9 · 75%Moderate 2 · 16.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
TDC compared with medical therapy for preventing composite recurrent stroke or TIA in people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
Population: patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: composite of recurrent stroke (non‐fatal or fatal) or transient ischemic attack (TIA) TDC vs medical therapy | RR 0.73 [0.45, 1.17] | 2 studies · 1323 participants | Low |
Primary outcome measure: composite of recurrent stroke (non‐fatal or fatal) or transient ischemic attack (TIA) stratified by the type of device ‐ Amplatzer PFO occluder TDC vs medical therapy | RR 0.47 [0.17, 1.32] | 1 study · 414 participants | Low |
TDC compared with medical therapy for preventing recurrent stroke in people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
Population: people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: recurrent stroke (non‐fatal or fatal) TDC vs medical therapy | RR 0.61 [0.29, 1.27] | 3 studies · 2303 participants | Low |
Primary outcome measure: recurrent stroke (non‐fatal or fatal) stratified by the type of device studied ‐ Amplatzer PFO occluder TDC vs medical therapy | RR 0.4 [0.14, 1.19] | 2 studies · 1394 participants | Low |
TDC compared with medical therapy for people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
Population: people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary outcome: all‐cause mortality at the end of TDC vs medical therapy | RR 0.65 [0.23, 1.84] | 3 studies · 2303 participants | Low |
Secondary outcome:total serious adverse events at the end of TDC vs medical therapy | RR 1.04 [0.88, 1.23] | 3 studies · 2303 participants | Low |
Secondary outcome: the incidence of atrial fibrillation TDC vs medical therapy | RR 3.5 [1.47, 8.35] | 3 studies · 2303 participants | Moderate |
TDC compared with medical therapy for people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack: time‐to‐event analyses
Population: people with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time‐to‐event analyses for recurrent stroke TDC vs medical therapy | HR 0.55 [0.26, 1.18] | 3 studies · 2303 participants | Low |
Time‐to‐event analyses for recurrent stroke stratified by the type of device ‐ Amplatzer PFO occluder TDC vs medical therapy | HR 0.38 [0.14, 1.02] | 2 studies · 1394 participants | Moderate |
Time‐to‐event analyses for composite of recurrent stroke or TIA TDC vs medical therapy | HR 0.69 [0.43, 1.13] | 2 studies · 1323 participants | Low |
Time‐to‐event analyses for composite of recurrent stroke or TIA stratified by the type of device studied ‐ Amplatzer PFO occluder TDC vs medical therapy | HR 0.45 [0.16, 1.28] | 1 study · 414 participants | Low |
CI: Confidence interval;HR: hazard ratio TDC vs medical therapy | no estimate extracted | NR | No studies |