Affiliation:
1. Quebec Heart and Lung Institute, Laval University Quebec City Quebec Canada
2. Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de Cardiologie (AP‐HP) Paris France
3. Centre Hospitalier Universitaire de Quebec Laval University Quebec City Quebec Canada
Abstract
Background
Scarce data exist on sex differences in patients with cryptogenic cerebrovascular events undergoing patent foramen ovale (PFO) closure. This study aimed to determine the sex differences in clinical profile, procedural characteristics, and long‐term outcomes of patients with cryptogenic cerebrovascular events undergoing PFO closure.
Methods and Results
A retrospective cohort was used, including 1076 consecutive patients undergoing PFO closure because of a cryptogenic cerebrovascular event. Patients were divided into 2 groups: 469 (43.6%) women and 607 (56.4%) men. The median follow‐up was 3 years (interquartile range, 2–8 years). Women were younger (46±13 versus 50±12 years;
P
<0.01) and had a higher risk of paradoxical embolism score (6.9±1.7 versus 6.6±1.6;
P
<0.01). Procedural characteristics and postprocedural antithrombotic therapy were similar. At follow‐up, there were no differences in atrial fibrillation (women versus men: 0.47 versus 0.97 per 100 patient‐years; incidence rate ratio [IRR], 0.55 [95% CI, 0.27–1.11];
P
=0.095; adjusted
P
=0.901), stroke (0.17 versus 0.07 per 100 patient‐years; IRR, 2.58 [95% CI, 0.47–14.1];
P
=0.274; adjusted
P
=0.201), or transient ischemic attack (0.43 versus 0.18 per 100 patient‐years; IRR, 2.58 [95% CI, 0.88–7.54];
P
=0.084; adjusted
P
=0.121); nevertheless, women exhibited a higher incidence of combined ischemic cerebrovascular events (0.61 versus 0.26 per 100 patient‐years; IRR, 2.58 [95% CI, 1.04–6.39];
P
=0.041; adjusted
P
=0.028) and bleeding events (1.04 versus 0.45 per 100 patient‐years; IRR, 2.82 [95% CI, 1.41–5.65];
P
=0.003; adjusted
P
=0.004).
Conclusions
Compared with men, women with cryptogenic cerebrovascular events undergoing PFO closure were younger and had a higher risk of paradoxical embolism score. After a median follow‐up of 3 years, there were no differences in stroke events, but women exhibited a higher rate of combined (stroke and transient ischemic attack) cerebrovascular events and bleeding complications. Additional studies are warranted to clarify sex‐related outcomes after PFO closure further.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
1 articles.
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1. Cryptogenic Stroke and PFO Closure: Does Sex Matter?;Journal of the American Heart Association;2023-10-03