Once a hole in the heart is plugged with a PFO closure device the common question asked by patients is how long does one need to continue antiplatelet therapy?

 

According to a new analysis reported in The Journal of the American College of Cardiology, long-term follow-up of patients who underwent patent foramen ovale (PFO) closure for cryptogenic stroke points to a very low rate of ischemic events and no device safety issues emerging beyond 10 years.   Look at the data for yourself here.

With the hole plugged, do patients still need aspirin?

Study Bottom Line:

Conclusions from the Study: PFO closure was associated with a low rate of ischemic events (stroke, 1%) at >10 years of follow-up. Major bleeding events occurred in 2% of the patients (all of them in patients on antiplatelet therapy). One-fifth of patients stopped the antithrombotic therapy during the follow-up period (the majority within the first-year post-PFO closure), and this was not associated with any increase in ischemic events at long-term follow-up.

Source: Journal of the American College of Cardiology 


My Bottom Line:

We still don’t have clear guidance. Future studies needed?  Absolutely Yes!  Not enough data tracked here especially as many young stroke survivors still have no long term guidelines and might not have been formally followed up with as part of this data set.

PFO Patient Registry??  None available for patients to reference at the moment. Sure wish PFO patients had one-we need to do better!


Finally, back to the main question “do I take these pill for life?”

From the study-

“For many of these patients—say, a 32-year-old patient— the question they have after closure is: do I have to take this pill for life? And we don’t have a clear response. As we say in the study, there are some guidelines talking about 5 years and others recommending lifelong antithrombotic therapy, but I think it’s an interesting message and somewhat provocative in our study that we have more bleeding events than ischemic events.”-

More resources on this topic:

Late Follow-up of PFO Closure for Stroke Raises Questions for Antiplatelet Duration

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Published by David Dansereau

Licensed Physical Therapist and Nutritionist in private consulting practice at PTC Physical Therapy Consulting and SmartMovesPT. Know-Stroke.org is my blog and members resource to raise stroke awareness and educate the public about reducing stroke risk as well as provide tips, tools and review new technologies for stroke recovery.

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