Sagris D, Georgiopoulos G, Perlepe K, et al. - Researchers conducted this systematic review and meta-analysis of randomized controlled trials 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 individuals (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. It was noted 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 reduction 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 vs aspirin is warranted.