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Patent foramen ovale closure in stroke patients with migraine in the CLOSE trial. The CLOSE-MIG study

Jean-Louis Mas 1, 2 Benoit Guillon 3 Anais Charles-Nelson 4 Valerie Domigo 5, 6 Laurent Derex 7 Evelyne Massardier 8 Caroline Arquizan 9 Fabrice Vuillier 10 Serge Timsit 11 Yannick Bejot 12, 13 Olivier Detante 14, 15 Denis Sablot 16, 17 Celine Guidoux 18, 19, 20 Igor Sibon 21 Nelly Dequatre-Ponchelle 22 Emmanuel Touze 23, 24 Sandrine Canaple 25, 26 Sonia Alamowitch 27 Pierre Aubry 28 Emmanuel Teiger 29 Genevieve Derumeaux 29 Gilles Chatellier 30, 31 
13 Registre Dijonnais des Accidents Vasculaires Cérébraux (AVC) - Dijon Stroke Registry
CEP - Centre d'épidémiologie des populations, CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
Abstract : Background and purpose The efficacy of patent foramen ovale (PFO) closure to reduce the frequency of migraine attacks remains controversial. Methods This was a planned sub-study in migraine patients enrolled in a randomized, clinical trial designed to assess the superiority of PFO closure plus antiplatelet therapy over antiplatelet therapy alone to prevent stroke recurrence in patients younger than 60 years with a PFO-associated cryptogenic ischaemic stroke. The main outcome was the mean annual number of migraine attacks in migraine patients with aura and in those without aura, as recorded at each follow-up visit by study neurologists. Results Of 473 patients randomized to PFO closure or antiplatelet therapy, 145 (mean age 41.9 years; women 58.6%) had migraine (75 with aura and 70 without aura). Sixty-seven patients were randomized to PFO closure and 78 to antiplatelet therapy. During a mean follow-up of about 5 years, there were no differences between antiplatelet-only and PFO closure groups in the mean annual number of migraine attacks, both in migraine patients with aura (9.2 [11.9] vs. 12.0 [19.1], p = 0.81) and in those without aura (12.1 [16.1] vs. 11.8 [18.4], p > 0.999). There were no differences between treatment groups regarding cessation of migraine attacks, migraine-related disability at 2 years and use of migraine-preventive drugs during follow-up. Conclusions In young and middle-aged adults with PFO-associated cryptogenic stroke and migraine, PFO closure plus antiplatelet therapy did not reduce the mean annual number of migraine attacks compared to antiplatelet therapy alone, in migraine patients both with and without aura.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03607030
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Soumis le : samedi 12 mars 2022 - 17:01:59
Dernière modification le : mercredi 28 septembre 2022 - 14:50:10

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Jean-Louis Mas, Benoit Guillon, Anais Charles-Nelson, Valerie Domigo, Laurent Derex, et al.. Patent foramen ovale closure in stroke patients with migraine in the CLOSE trial. The CLOSE-MIG study. European Journal of Neurology, Wiley, 2021, 28 (8), pp.2700-2707. ⟨10.1111/ene.14892⟩. ⟨hal-03607030⟩

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