A meta-analysis of case-control studies of the association of migraine and patent foramen ovale

Objectives: To establish quantitative evidence, we performed the first meta-analysis of case-control studies assessing the relationship between migraine and patent foramen ovale (PFO). Methods: MEDLINE and EMBASE were searched through April 2015 using PubMed and OVID. Eligible studies were case-control studies reporting PFO (or migraine) prevalence in migraine patients versus no migraine subjects (or PFO patients versus no-PFO subjects). Results: Of 395 potentially relevant articles screened initially, 21 eligible studies enrolling a total of 5572 participants were identified and included. Pooled analyses demonstrated statistically significant 3.36-fold migraine-with-aura [odds ratio (OR), 3.36; 95% confidence interval (CI), 2.04-5.55; p < 0.00001] and 2.46-fold migraine-with/without-aura prevalence (OR, 2.46; 95% CI, 1.55-3.91; p = 0.0001) but statistically non-significant 1.30-fold migraine-without-aura prevalence (OR, 1.30; 95% CI, 0.85-1.99; p = 0.22) in PFO patients relative to no-PFO subjects. Conclusions: PFO is associated with 3.4-fold migraine-with-aura and 2.5-fold migraine-with/without-aura prevalence but unassociated with migraine-without-aura prevalence. (C) 2015 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.