Antithrombotic Therapy Duration after Patent Foramen Ovale Closure for Stroke Prevention: Impact on Long-Term Outcome.

Kefer, Joëlle;Carbonez, Karlien;Pierard, Sophie;Mouthuy, François-Pierre;Pasquet, Agnes;et.al.
(2022) Journal of Interventional Cardiology : an international forum for global cardiovascular therapies — Vol. 2022, p. 6559447 [1-11] (2022)

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BACKGROUND: The optimal duration of antithrombotic therapy (ATT) after patent foramen ovale (PFO) closure remains under debate. This study sought to compare the clinical outcome of patients receiving antithrombotic agents for a short (6 months) versus extended (>6 months) period after the procedure. METHODS: This was a retrospective cohort study using a propensity score matching analysis on 259 consecutive patients (131 males, 43 ± 10 years) undergoing PFO closure due to cryptogenic stroke, with complete follow-up (median duration of 10 [4-13] years). The outcome was compared between patients receiving short-term (Group short, N = 88) versus extended ATT (Group long, N = 171). RESULTS: The PFO closure device was successfully implanted in all cases, with 3% of minor complications. After propensity score matching, there were no differences between Groups short and long in the rate of stroke (0.3 vs. 0.4% patient-year, p=1.00), bleeding (2 vs. 2% patient-year, p=0.17), and device thrombosis (0.3 vs. 0.1% patient-year; p=0.60). Univariate analysis showed that short-term ATT was not associated with an increased risk of recurrent stroke (HR: 1.271 [95% CI: 0.247-6.551], p=0.775) or prosthesis thrombus (HR: 0.50 [95% CI: 0.070-3.548], p=0.72). Kaplan-Meier analysis revealed similar overall survival in Group short and long (100 vs. 99 ± 1%, respectively; p=0.25). CONCLUSIONS: Short-term (6 months) ATT after PFO closure did not impair the clinical outcome, with a preserved low rate of recurrent stroke (0.3% patient-year) and device thrombosis (0.2% patient-year) at 10-year follow-up.
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Kefer, J., Carbonez, K., Pierard, S., Mouthuy, F.-P., Peeters, A., Hermans, C., Lambert, C., de Meester de Ravenstein, C., Sluysmans, T., & Pasquet, A. (2022). Antithrombotic Therapy Duration after Patent Foramen Ovale Closure for Stroke Prevention: Impact on Long-Term Outcome. Journal of Interventional Cardiology : an international forum for global cardiovascular therapies, 2022, 6559447 [1-11]. https://doi.org/10.1155/2022/6559447 (Original work published 2022)