Wessler Benjamin S, Kent David M
Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 63, Boston, MA 02111, USA; Division of Cardiology, Tufts Medical Center, 800 Washington Street, Box 63, Boston, MA 02111, USA.
Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 63, Boston, MA 02111, USA.
Neurol Clin. 2015 May;33(2):491-500. doi: 10.1016/j.ncl.2015.01.002. Epub 2015 Feb 28.
Patent foramen ovale (PFO) is common and only rarely related to stroke. The high PFO prevalence in healthy individuals makes for difficult decision making when a PFO is found in the setting of a cryptogenic stroke, because the PFO may be an incidental finding. Recent clinical trials of device-based PFO closure have had negative overall summary results; these trials have been limited by low recurrence rates. The optimal antithrombotic strategy for these patients is also unknown. Recent work has identified a risk score that estimates PFO-attributable fractions based on individual patient characteristics, although whether this score can help direct therapy is unclear.
卵圆孔未闭(PFO)很常见,与中风的相关性很小。健康个体中PFO的高患病率使得在隐源性中风患者中发现PFO时难以做出决策,因为PFO可能是偶然发现的。最近基于装置的PFO封堵临床试验的总体汇总结果为阴性;这些试验受到低复发率的限制。这些患者的最佳抗栓策略也尚不清楚。最近的研究确定了一个风险评分,该评分可根据个体患者特征估计PFO归因分数,尽管该评分是否有助于指导治疗尚不清楚。