Sex-Based Differences in Long-Term Outcomes Following Transcatheter Closure of Patent Foramen Ovale for Cryptogenic Stroke.

Autor:	Flores-Umanzor E; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H).; Cardiology Department, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Spain (E.F.-U.)., Abrahamyan L; Toronto General Hospital Research Institute, University Health Network, ON, Canada (L.-A., A.A., K.E.)., Asghar A; Toronto General Hospital Research Institute, University Health Network, ON, Canada (L.-A., A.A., K.E.)., Schrutka L; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H).; Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria (L.S.)., Everett K; Toronto General Hospital Research Institute, University Health Network, ON, Canada (L.-A., A.A., K.E.)., Lee DS; ICES, Toronto, ON, Canada (D.S.L.).; Division of Cardiology, Peter Munk Cardiac Centre, UHN, Toronto, ON, Canada (D.S.L.)., Osten M; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H)., Benson L; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H).; The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, ON, Canada (L.B.)., Horlick E; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H).
Jazyk:	angličtina
Zdroj:	Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2024 Nov; Vol. 17 (11), pp. e014467. Date of Electronic Publication: 2024 Nov 19.
DOI:	10.1161/CIRCINTERVENTIONS.124.014467
Abstrakt:	Background: Evidence from trials suggests that patent foramen ovale closure is superior to medical therapy alone in reducing stroke recurrence in men but not in women. Evidence from real-world data on the impact of sex on outcomes after patent foramen ovale closure, however, remains scarce. Therefore, the present study aimed to assess sex-based differences in long-term outcomes after transcatheter closure of patent foramen ovale. Methods: This was a single-center, retrospective cohort study enrolling patients who underwent transcatheter patent foramen ovale closure to prevent recurrent cerebrovascular events. Detailed information from medical charts was entered into a clinical registry, which has been linked to population-based administrative health databases in Ontario. Procedural, short, and long-term outcomes have been compared by sex. Results: Of the 783 patients included in the sample, 349 (44.5%) were women and 434 (55.5%) were men. Women were younger and had a higher rate of migraine, while men had a higher prevalence of cardiovascular risk factors. No differences were observed in procedural and 30-day outcomes by sex. At a median follow-up of 14 years, the event rates of recurrent cerebrovascular events, survival, and new-onset atrial fibrillation were not different by sex. In adjusted analysis, men experienced higher rates of pacemaker implantation (hazard ratio, 5.62 [95% CI, 1.57-20.1]). Conclusions: No sex-based differences in recurrent cerebrovascular events, survival, or new-onset atrial fibrillation were observed in this study, suggesting equal benefits for both sexes. Future studies should report outcomes by sex to enhance the reproducibility of our findings and help support guideline development. Competing Interests: Dr Horlick is a consultant for Abbott, Edwards, and Medtronic. He received research grants from Abbott and Occlutech for other projects. The Structural Heart Disease Program at the University Health Network receives educational support from Abbott, Edwards, and Medtronic. Abbott, Edwards, and Medtronic were not involved in the planning or execution of this study and have not seen or reviewed this article. Dr Lee is the Ted Rogers Chair in Heart Function Outcomes, a joint Hospital-University Chair of the University Health Network and the University of Toronto. The other authors report no conflicts.
Databáze:	MEDLINE
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