Diener HC, Chutinet A, Easton JD, et al. - In patients with embolic stroke of undetermined source (ESUS) and patent foramen ovale (PFO), more effective stroke prevention may be conferred by anticoagulation vs antiplatelets when interventional closure is not performed, so researchers updated this meta-analysis comparing the impact of anticoagulant and antiplatelet therapy on ischemic stroke in patients with PFO, to include the RE-SPECT ESUS study. Patients with ESUS randomized to dabigatran (150/110 mg BID) or aspirin (100 mg QD) from the RE-SPECT ESUS study were involved in this analysis. In 680 of 5,388 (12.6%) patients with reported PFO status, PFO was present. In patients with and without PFO, the risk of recurrent stroke with dabigatran vs aspirin was comparable. The meta-analysis found no statistically significant difference between anticoagulant and antiplatelet therapy for ischemic stroke in patients with PFO. More data are required to direct antithrombotic therapy in this population.