Key result
PFO in acute PE is linked to ~436% higher ischemic stroke risk.
Why the study?
Patients with acute pulmonary hypertension during acute PE can develop stroke due to paradoxical embolism via a PFO, but the associated risks of ischemic stroke and mortality required systematic evaluation.
Does the presence of a patent foramen ovale increase the risk of ischemic stroke in adult patients with acute pulmonary embolism?
Population
1197 adult patients diagnosed with PE across 8 studies
Comparison
PE with PFO vs PE without PFO
Design
Systematic review and meta-analysis
Authors
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May prompt PFO screening for stroke risk stratification in acute PE; leaves open whether closure or intensified therapy alters outcomes.
Meta-Analysis (n=1,197)
Does the presence of a patent foramen ovale increase the risk of ischemic stroke in adult patients with acute pulmonary embolism?
Odds Ratio: 5.36 (95% CI 3.2–8.99)
Absolute Event Rate: 19.5% vs 4.5%
p-value: p=< 0.00001
In patients with acute pulmonary embolism, the presence of a patent foramen ovale is associated with a more than 5-fold increased risk of ischemic stroke.
Lucas et al. (2024) conducted a meta-analysis in Pulmonary embolism (n=1,197). Patent foramen ovale (PFO) vs. No PFO was evaluated on Ischemic stroke (OR 5.36, 95% CI 3.20-8.99, p=< 0.00001). In patients with acute pulmonary embolism, the presence of a patent foramen ovale was significantly associated with a higher risk of ischemic stroke (OR 5.36; 95% CI 3.20-8.99; p<0.00001).
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