RoPE Score as a Predictor of Recurrent Ischemic Events After Percutaneous Patent Foramen Ovale Closure

• Autor(a) principal: Morais, LA
• Data de Publicação: 2018
• Outros Autores: Sousa, L, Fiarresga, A, Martins, JD, Timóteo, AT, Viveiros Monteiro, A, Soares, C, Agapito, A, Pinto, MF, Cruz Ferreira, R
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3408
• topic: Adult; Brain Ischemia/diagnosis; Female; Follow-Up Studies; Foramen Ovale, Patent/complications; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Recurrence; Stroke/etiology; Treatment Outcome; Decision Support Techniques; Secondary Prevention; HSM CAR; HSM CAR PED; Brain Ischemia/etiology; Brain Ischemia/prevention & control; Foramen Ovale, Patent/surgery; Stroke/prevention & control

The benefits of patent foramen ovale (PFO) closure for cryptogenic stroke secondary prevention are still debated. The Risk of Paradoxical Embolism (RoPE) study developed a score to improve patient selection for this procedure. We proposed to assess the validity of this score to assess the prognostic impact of PFO closure.From 2000 to 2014, all consecutive patients submitted to PFO closure were included in a prospective registry in a university center. The primary endpoint was recurrent ischemic cerebrovascular events and the secondary endpoints were all-cause, neurological, and cardiac mortality rates and new-onset atrial fibrillation (NOAF) rates. In total, 403 patients were included in the study (women: 52.1%; mean age: 44.7 ± 10.9 years). The mean follow-up period was 6.4 ± 3.7 years. Immediate success was achieved in 97% patients. There were 23 (5.8%) ischemic cerebrovascular events, 8 (2.0%) deaths, and 17 (4.3%) NOAFs. The mean RoPE score was 6.10 ± 1.79. Smoker status, coronary artery disease, lower RoPE score, and higher left atrial dimensions were predictors of the primary endpoint. However, a lower RoPE score and coronary artery disease remained independent predictors in multivariate analysis.RoPE score was shown to be an independent predictor of recurrent ischemic cerebrovascular events, and a score of ≤ 6 was shown to identify patients with significantly higher risk of mortality and recurrent ischemic events.