Anticoagulation vs. Antiplatelets in Treating Patients with Stroke and PFO

A prespecified subgroup analysis of a randomized trial showed no significant difference between the drug categories in secondary stroke prevention in patients with patent foramen ovale. The evidence to date, however, leaves the question unsettled.

Most clinical trials involving patients with ischemic stroke and patent foramen ovale (PFO) have focused on device closure of the PFO versus medical therapy. Fewer studies have compared anticoagulation against antiplatelet therapy. The paradoxical embolus concept postulates that a venous clot traverses the PFO and enters the arterial circulation. Given the accepted role of anticoagulation in venous thrombosis treatment, is there potential value in anticoagulation for stroke prevention in patients with a PFO?

Investigators conducted a prespecified subgroup analysis of a large clinical trial (NAVIGATE ESUS) that compared rivaroxaban with aspirin in patients with a stroke pattern consistent with embolic stroke of unknown source (ESUS). This was…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Anticoagulation vs. Antiplatelets in Treating Patients with Stroke and PFO

Topics

Reviewing Author