Grant: Project Grant

Stroke ranks as the second leading cause of global mortality and holds the position of the primary cause of adult disability within Canada. Extensive clinical investigations have revealed an association between unexplained strokes, often referred to as cryptogenic strokes, and a cardiac anomaly called patent foramen ovale (PFO). PFO manifests as a small hole between the heart's upper chambers, which normally closes after birth. While the presence of PFO usually bears no health implications for the majority, it might heighten the risk of a stroke if a small blood clot traverses the opening and reaches the brain. Doctors have found that they can reduce the risk of stroke for people who have had repeated strokes by closing this hole using a minimally invasive procedure. However, the majority of existing clinical studies in this field excluded subjects aged 60 and above. Therefore, whether these results may be applied to an older population remains uncertain. Some initial studies have exhibited promising indications, suggesting that PFO closure in older patients afflicted with cryptogenic stroke is both safe and associated with a remarkably low stroke incidence during medium- and long-term follow-up. This would support the conduction of a randomized trial to get stronger evidence. The available data concerning older patients is limited, and considering that more people are getting older and strokes are still causing a lot of problems and sickness, randomized clinical trials are needed to better assess the benefit of PFO closure in this elderly population. Therefore, this study proposal sought to determine the efficacy of PFO closure for the prevention of recurrent stroke in older patients with PFO and cryptogenic stroke.