Atrial Fibrillation, Atrial Flutter, Patent Foramen Ovale, Stroke
Conditions
Brief summary
Patent foramen ovale (PFO) is a prevalent cause of ischemic stroke and transient ischemic attack (TIA) in young patients. Its role as a cause of cerebrovascular events in the older population is more controversial because of other competing causes are more frequent in the elderly. Recent randomized controlled trials (RCTs) have shown that PFO closure is associated with a 59% relative risk reduction in the risk of recurrent ischemic stroke. As such, the number of PFO closure procedures are expected to increase substantially in the upcoming years. Real world data (RWD) informing on the medical management, the risk of stroke recurrence, incident atrial fibrillation, and other outcomes in stroke patients with PFO, with and without PFO closure, will become crucial for understanding how results from RCTs are translated into clinical practice globally. The IMPROVE (International Multicenter Patent foRamen OVale & strokE) Registry is an observational, multicenter, international registry of men and women with an ischemic stroke or TIA. The aim is to enroll 8,800 patient-years at ≥50 sites in ≥20 countries. The IMPROVE Registry will provide important information about the management and related outcomes of patients with ischemic stroke or TIA and PFO throughout different regions of the world and across a wide spectrum of healthcare systems.
Interventions
DEVICEPFO closure
PFO closure after stroke or transient ischemic attack
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(all of the following criteria should be fulfilled) * Age ≥18 years * Ischemic stroke or TIA within 5 years and 1 year before inclusion in the registry. Patients with cerebrovascular events occurred within one year before the inclusion in the registry should be part of the prospective cohort. * Ischemic stroke is defined as: * focal neurological deficit of central origin lasting ≥24 hours -except for death within 24hrs- with or without imaging confirmation of cerebral infarction; or * focal neurological deficit of central origin lasting \<24 hours with corresponding imaging evidence of cerebral infarction; or * focal neurological deficit of central origin lasting \<24 hours in patients receiving IV thrombolysis or endovascular thrombectomy with or without imaging confirmation of cerebral infarction; or * non-focal encephalopathy lasting more than 24 hours -except for death within 24hrs- with imaging evidence of cerebral infarction; or * acute and permanent retinal ischemia of arterial origin. * TIA is defined as: * focal neurological deficit of central origin lasting \<24 hours without corresponding imaging evidence of cerebral infarction in patients not receiving IV thrombolysis or endovascular thrombectomy. * Confirmed patent foramen ovale.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recurrent stroke | Duration of follow-up (minimum of 3 months) | Recurrent hemorrhagic or ischemic stroke |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incident atrial fibrillation | Duration of follow-up (minimum of 3 months) | New diagnosis of atrial fibrillation after the index date |
| Proportion of patients undergoing PFO closure | Within 12 months of the index diagnosis of PFO after the stroke or transient ischemic attack | Proportion of patients undergoing PFO closure |
Other
| Measure | Time frame | Description |
|---|---|---|
| Recurrent stroke or death | Duration of follow-up (minimum of 3 months) | Recurrent hemorrhagic or ischemic stroke, or death |
| Recurrent stroke or myocardial infarction | Duration of follow-up (minimum of 3 months) | Recurrent hemorrhagic or ischemic stroke, or myocardial infarction |
Countries
Canada
Outcome results
None listed