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Answer 5
  1. Initiate aspirin 325 mg/day. A multicenter study comparing aspirin and warfarin for treatment of stroke patients with PFO found no difference in stroke risk between treatment groups but found a significantly higher rate of hemorrhage in the warfarin-treated group.5 PFO closure would not be recommended in a patient with a first stroke who has not yet been treated with an antithrombotic medication.

    5. Homma S, Sacco RL, Di Tullio MR, et al; PFO in Cryptogenic Stroke Study (PICSS) Investigators. Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation 2002;105:2625–31.

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