(P080) SEX-BASED DIFFERENCES IN LONG-TERM OUTCOMES FOLLOWING TRANSCATHETER CLOSURE OF PATENT FORAMEN OVALE FOR CRYPTOGENIC STROKE

Background: Evidence from trials suggests that patent foramen ovale (PFO) closure is superior to medical therapy alone in reducing stroke recurrence in males but not in females. Evidence from real-world data on the impact of sex on outcomes after PFO closure, however, remains scarce. Therefore, the present study aimed to assess sex-based differences in long-term outcomes after transcatheter closure of PFO.

METHODS AND RESULTS: This was a single center, retrospective cohort study enrolling patients who underwent transcatheter PFO closure to prevent recurrent cerebrovascular events. Detailed information from medical charts was entered into a clinical registry, which has been linked to population-based administrative health databases in Ontario. Procedural, short, and long-term outcomes have been compared by sex.

From 783 patients included in the sample, 349 (44.5%) were female and 439 (55.5%) were male. Females were younger and had a higher rate of migraine, while males had a higher prevalence of cardiovascular risk factors. No differences were observed in procedural and 30-day outcomes by sex. At a median follow-up of 14 years, the event rates of recurrent cerebrovascular events, survival, the composite outcome of stroke/TIA/death (Figure 1) and new onset atrial fibrillation were not different by sex. In adjusted analysis, males experienced higher rates of pacemaker implantation (hazard ratio = 5.62, 95% confidence interval: 1.57 to 20.1).

Conclusion: Male patients experience higher rates of pacemaker implantation after PFO closure. Future studies should report outcomes by sex to enhance the reproducibility of our findings and help support guideline development.