{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:53:30Z","timestamp":1790070810133,"version":"4.0.1"},"update-to":[{"DOI":"10.12688\/f1000research.27622.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000}}],"reference-count":10,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kathleen & Dr. Henry Barnett Research Chair in Stroke Research"},{"DOI":"10.13039\/100010564","name":"Academic Medical Organization of Southwestern Ontario","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010564","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Edward and Alma Saraydar Neurosciences Fund"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Thrombi identified on echocardiography at the time of straddling a patent foramen ovale (PFO) constitute a medical emergency with an associated imminent risk of death.\u00a0 Ischemic stroke (IS) and myocardial infarction (MI) occurring in patients with a thrombus straddling a PFO (TSPFO) may be associated with increased risk of in-hospital death. Variables associated with increased risk of death in women and men may be different. We will perform a systematic review of case reports and cases series of patients with a TSPFO to assess if IS and MI are associated with increased risk of in-hospital death and we will further stratify analyses by sex.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    This systematic review will include all case reports and case series of adult patients (18-year-old or older) with echocardiographic or pathological (e.g. at autopsy for older reports) evidence of a TSPFO published between inception and June 30, 2020, in any language. We will search in PubMed and Embase databases. Two reviewers will independently screen titles and abstracts, retrieve full texts, and extract the data in a predesigned form. We will apply a multivariable logistic regression analysis to estimate the association of IS and MI with in-hospital mortality. We will stratify analyses by sex.\u00a0\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Discussion:<\/ns4:bold>\n                    IS and MI in patients with TSPFO could potentially be associated with worse outcomes if they are not timely identified or left untreated.\u00a0 Both acute IS and MI require specific treatment (e.g. thrombolysis, primary coronary intervention, or mechanical thrombectomy) that may be influenced by the therapy instituted for the TSPFO. Knowing the incidence of acute IS and MI among patients diagnosed with TSPFO and whether they are associated with an increased risk of death would help to improve the management of this medical emergency.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Protocol registration<\/ns4:bold>\n                    :\u00a0CRD42020216118, PROSPERO.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.27622.2","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T09:35:19Z","timestamp":1620207319000},"page":"1437","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of in-hospital death in patients with a thrombus straddling a patent foramen ovale: protocol of a systematic review"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0257-3107","authenticated-orcid":false,"given":"Amado","family":"Jim\u00e9nez-Ruiz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palak","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Gibson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Camilo","family":"Vargas-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6425-9343","authenticated-orcid":false,"given":"Luciano A.","family":"Sposato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"17-20","DOI":"10.1016\/s0025-6196(12)60336-x","article-title":"Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts.","volume":"59","author":"P Hagen","year":"1984","journal-title":"Mayo Clin Proc."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"281","DOI":"10.3389\/fneur.2020.00281","article-title":"Epidemiology of Patent Foramen Ovale in General Population and in Stroke Patients: A Narrative Review.","volume":"11","author":"I Koutroulou","year":"2020","journal-title":"Front Neurol."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"1021-1022","DOI":"10.1067\/mje.2002.121279","article-title":"Thrombus-in-transit and paradoxical embolism.","volume":"15","author":"K Aggarwal","year":"2002","journal-title":"J Am Soc Echocardiogr."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"164-170","DOI":"10.1378\/chest.09-0961","article-title":"Impending paradoxical embolism: systematic review of prognostic factors and treatment.","volume":"137","author":"P Myers","year":"2010","journal-title":"Chest."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"879-885","DOI":"10.1016\/0002-8703(88)90356-0","article-title":"Paradoxical coronary embolism: case report and review of the literature.","volume":"116","author":"A Jungbluth","year":"1988","journal-title":"Am Heart J."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"60-63","DOI":"10.1136\/bmjebm-2017-110853","article-title":"Methodological quality and synthesis of case series and case reports.","volume":"23","author":"M Murad","year":"2018","journal-title":"BMJ Evid Based Med."},{"key":"ref-7","first-page":"800","article-title":"Point of Care Echocardiography in an Irish Critical Care Unit.","volume":"111","author":"D Kuriakose","year":"2018","journal-title":"Ir Med J."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"109-116","DOI":"10.1016\/j.cjca.2017.08.018","article-title":"Contemporary Application of Point-of-Care Echocardiography in the Emergency Department.","volume":"34","author":"J Chenkin","year":"2018","journal-title":"Can J Cardiol."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"756-763","DOI":"10.7326\/M18-3485","article-title":"Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism: A Prospective Cohort Study.","volume":"170","author":"E Le Moigne","year":"2019","journal-title":"Ann Intern Med."},{"key":"ref-10","article-title":"PRISMA-P-checklist. Determinants of in-hospital death in patients with a thrombus straddling a patent foramen ovale: protocol of a systematic review.","author":"P Shah","year":"2020","journal-title":"figshare."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T05:25:17Z","timestamp":1621488317000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,5]]},"references-count":10,"URL":"https:\/\/doi.org\/10.12688\/f1000research.27622.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.56395.r84539","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.56395.r84540","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.56395.r84540","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.56395.r84539","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,5]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.56395.r84539, Paolo Eusebi, Regional Health Authority of Umbria, Perugia, Italy, 19 May 2021, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2#referee-response-84539","order":0,"name":"referee-response-84539","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.56395.r84540, Leonardo Varotto, Department of Cardiology, San Bortolo Hospital, viale Rodolfi, Vicenza, 36100, Italy, 20 May 2021, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/9-1437\/v2#referee-response-84540","order":1,"name":"referee-response-84540","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"LAS is supported by the Kathleen & Dr. Henry Barnett Research Chair in Stroke Research (Western University, London, Canada); the Edward and Alma Saraydar Neurosciences Fund (London Health Sciences Foundation, London, Canada); and the Opportunities Fund of the Academic Health Sciences Centre Alternative Funding Plan of the Academic Medical Organization of Southwestern Ontario (AMOSO) (Ontario, Canada). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}