PHILADELPHIA — The results of two long-awaited clinical trials, testing a closure device versus medication to prevent stroke recurrence in young stroke survivors who have an opening in the atrial wall, have not provided enough evidence to conclude who, if anyone, is likely to benefit from the interventional procedure, according to an accompanying editorial in the New England Journal of Medicine co-authored by a Perelman School of Medicine researcher at the University of Pennsylvania.
Young survivors of stroke are more likely to have a patent foramen ovale (PFO), an opening in the wall between upper chambers of the heart that is found in about one quarter of the population. This opening can allow a small clot to pass through the heart, which can result in a stroke. Neither of the two studies published in the New England Journal definitively showed that using a device to close the PFO was more effective at preventing a secondary stroke than medications to prevent clots.
In the editorial, co-authored by Steven Messe, MD, assistant professor of Neurology at the Perelman School of Medicine, the authors note that, "given the prevalence of patent foramen ovale in the general population, the enormous potential for overuse of percutaneous closure of a patent foramen ovale, and the relatively low risk of stroke in patients who are treated medically, the routine use of this therapy seems unwise without a clearer view of who, if anyone, is likely to benefit."
David Kent, MD, from Tufts University, co-authored the editorial with Dr. Messe. The editorial is online at the New England Journal of Medicine, as are the results from the two clinical trials, RESPECT and PC Trial.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $5.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 18 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $373 million awarded in the 2015 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2015, Penn Medicine provided $253.3 million to benefit our community.