Sagris D, Georgiopoulos G, Perlepe K, et al. - Researchers conducted this systematic review and meta-analysis to compare anticoagulant or antiplatelet treatment in patients with stroke/transient ischemic attack and medically treated patent foramen ovale using the terms: “cryptogenic or embolic stroke of undetermined source” and “stroke or cerebrovascular accident or transient ischemic attack” and “patent foramen ovale or patent foramen ovale or paradoxical embolism” and “trial or study” and “antithrombotic or anticoagulant or antiplatelet.” Participants in the study were 1,720 patients (mean follow-up 2.3 ± 0.5 years). The authors discovered that stroke recurrence occurred in anticoagulant-assigned patients at a rate of 1.73 per 100 patient-years and in antiplatelet-assigned patients at 2.39. They observed that major bleeding occurred in anticoagulant-assigned patients at a rate of 1.16 per 100 patient-years and in antiplatelet-assigned patients at 0.68. Compared with antiplatelet-assigned, a large decline of stroke recurrence in anticoagulant-assigned patients cannot be excluded, without significant variations in major bleeding. An appropriately powered randomized controlled trial of a non–vitamin K antagonist compared with aspirin is warranted.