Cryptogenic Stroke and Patent Foramen Ovale
Authors: Ashok K. Malani, Hussam Ammar
Journal: Annals of Internal Medicine (2006)

Letters5 September 2006Cryptogenic Stroke and Patent Foramen OvaleAshok K. Malani, MD and Hussam Ammar, MDAshok K. Malani, MDFrom Heartland Regional Medical Center, St. Joseph, MO 64506.Search for more papers by this author and Hussam Ammar, MDFrom Heartland Regional Medical Center, St. Joseph, MO 64506.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-5-200609050-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: In their comprehensive and informative Update (1), Drs. Holloway and Józefowicz suggest using warfarin for secondary prevention of stroke in patients with atrial septal defect. The current literature has no strong evidence to support this view, and therefore the current guidelines from the American Academy of Neurology state that “the evidence is insufficient to determine whether aspirin or warfarin is superior in preventing recurrent stroke or death in patients with patent foramen ovale (PFO) alone” (2). However, the American Academy of Neurology does recommend warfarin therapy in patients with patent foramen ovale and evidence of deep venous ...References1. Holloway RG, Józefowicz RF. Update in neurology. Ann Intern Med. 2006;144:421-6. [PMID: 16549854] LinkGoogle Scholar2. Messe SR, Silverman IE, Kizer JR, Homma S, Zahn C, Gronseth G, et al. Practice parameter: recurrent stroke with patent foramen ovale and atrial septal aneurysm: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2004;62:1042-50. [PMID: 15078999] CrossrefMedlineGoogle Scholar3. Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G, et al. Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N Engl J Med. 2001;345:1740-6. [PMID: 11742048] CrossrefMedlineGoogle Scholar4. Homma S, Sacco RL, Di Tullio MR, Sciacca RR, Mohr JP. Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation. 2002;105:2625-31. [PMID: 12045168] CrossrefMedlineGoogle Scholar5. Kizer JR, Devereux RB. Clinical practice. Patent foramen ovale in young adults with unexplained stroke. N Engl J Med. 2005;353:2361-72. [PMID: 16319385] CrossrefMedlineGoogle Scholar6. Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:483S-512S. [PMID: 15383482] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Ashok K. Malani, MD; Hussam Ammar, MDAffiliations: From Heartland Regional Medical Center, St. Joseph, MO 64506.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpdate in Neurology Robert G. Holloway Jr. and Ralph F. Józefowicz Cryptogenic Stroke and Patent Foramen Ovale Robert G. Holloway Jr. and Ralph F. Józefowicz Metrics 5 September 2006Volume 145, Issue 5Page: 393-394KeywordsConflicts of interestDeep vein thrombosisNeurologyRetrospective studiesRisk managementStrokeThorax ePublished: 5 September 2006 Issue Published: 5 September 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...