@article{uoadl:3492351,
    volume = "55",
    number = "4",
    pages = "908 – 918",
    journal = "ISRN Stroke",
    issn = "2090-9454",
    keywords = "Anticoagulants; Aortic Dissection; Arteries; Atrial Fibrillation; Carotid Artery, Internal, Dissection; Fibrinolytic Agents; Hemorrhage; Humans; Ischemic Stroke; Platelet Aggregation Inhibitors; Retrospective Studies; Stroke; Treatment Outcome; anticoagulant agent; antithrombocytic agent; anticoagulant agent; antithrombocytic agent; fibrinolytic agent; adult; anticoagulant therapy; anticoagulation; artery dissection; Article; cerebrovascular accident; cohort analysis; controlled study; correlation analysis; dual antiplatelet therapy; female; follow up; human; Kaplan Meier method; major clinical study; male; observational study; retrospective study; risk assessment; sensitivity analysis; aortic dissection; artery; atrial fibrillation; bleeding; carotid artery injury; cerebrovascular accident; clinical trial; complication; ischemic stroke; multicenter study; treatment outcome",
    BIBTEX_ENTRY = "article",
    year = "2024",
    author = "Yaghi, Shadi and Shu, Liqi and Mandel, Daniel and Leon Guerrero, Christopher R. and Henninger, Nils and Muppa, Jayachandra and Affan, Muhammad and Ul Haq Lodhi, Omair and Heldner, Mirjam R. and Antonenko, Kateryna and Seiffge, David and Arnold, Marcel and Salehi Omran, Setareh and Crandall, Ross and Lester, Evan and Lopez Mena, Diego and Arauz, Antonio and Nehme, Ahmad and Boulanger, Marion and Touze, Emmanuel and Sousa, Joao Andre and Sargento-Freitas, Joao and Barata, Vasco and Castro-Chaves, Paulo and Brito, Maria Teresa and Khan, Muhib and Mallick, Dania and Rothstein, Aaron and Khazaal, Ossama and Kaufmann, Josefin E. and Engelter, Stefan T. and Traenka, Christopher and Aguiar De Sousa, Diana and Soares, Mafalda and Rosa, Sara and Zhou, Lily W. and Gandhi, Preet and Field, Thalia S. and Mancini, Steven and Metanis, Issa and Leker, Ronen R. and Pan, Kelly and Dantu, Vishnu and Baumgartner, Karl and Burton, Tina and Von Rennenberg, Regina and Nolte, Christian H. and Choi, Richard and Macdonald, Jason and Bavarsad Shahripour, Reza and Guo, Xiaofan and Ghannam, Malik and Almajali, Mohammad and Samaniego, Edgar A. and Sanchez, Sebastian and Rioux, Bastien and Zine-Eddine, Faycal and Poppe, Alexandre and Fonseca, Ana Catarina and Baptista, Maria Fortuna and Cruz, Diana and Romoli, Michele and De Marco, Giovanna and Longoni, Marco and Keser, Zafer and Griffin, Kim and Kuohn, Lindsey and Frontera, Jennifer and Amar, Jordan and Giles, James and Zedde, Marialuisa and Pascarella, Rosario and Grisendi, Ilaria and Nzwalo, Hipolito and Liebeskind, David S. and Molaie, Amir and Cavalier, Annie and Kam, Wayneho and Mac Grory, Brian and Al Kasab, Sami and Anadani, Mohammad and Kicielinski, Kimberly and Eltatawy, Ali and Chervak, Lina and Chulluncuy-Rivas, Roberto and Aziz, Yasmin and Bakradze, Ekaterina and Tran, Thanh Lam and Rodrigo-Gisbert, Marc and Requena, Manuel and Saleh Velez, Faddi and Ortiz Gracia, Jorge and Mudassani, Varsha and De Havenon, Adam and Vishnu, Venugopalan Y. and Yaddanapudi, Sridhara and Adams, Latasha and Browngoehl, Abigail and Ranasinghe, Tamra and Dunston, Randy and Lynch, Zachary and Penckofer, Mary and Siegler, James and Mayer, Silvia and Willey, Joshua and Zubair, Adeel and Cheng, Yee Kuang and Sharma, Richa and Marto, João Pedro and Mendes Ferreira, Vítor and Klein, Piers and Nguyen, Thanh N. and Asad, Syed Daniyal and Sarwat, Zoha and Balabhadra, Anvesh and Patel, Shivam and Secchi, Thais and Martins, Sheila and Mantovani, Gabriel and Kim, Young Dae and Krishnaiah, Balaji and Elangovan, Cheran and Lingam, Sivani and Quereshi, Abid and Fridman, Sebastian and Alvarado, Alonso and Khasiyev, Farid and Linares, Guillermo and Mannino, Marina and Terruso, Valeria and Vassilopoulou, Sofia and Tentolouris, Vasilis and Martinez-Marino, Manuel and Carrasco Wall, Victor and Indraswari, Fransisca and El Jamal, Sleiman and Liu, Shilin and Alvi, Muhammad and Ali, Farman and Sarvath, Mohammed and Morsi, Rami Z. and Kass-Hout, Tareq and Shi, Feina and Zhang, Jinhua and Sokhi, Dilraj and Said, Jamil and Simpkins, Alexis N. and Gomez, Roberto and Sen, Shayak and Ghani, Mohammad and Elnazeir, Marwa and Xiao, Han and Kala, Narendra and Khan, Farhan and Stretz, Christoph and Mohammadzadeh, Nahid and Goldstein, Eric and Furie, Karen",
    abstract = "BACKGROUND: Small, randomized trials of patients with cervical artery dissection showed conflicting results regarding optimal stroke prevention strategies. We aimed to compare outcomes in patients with cervical artery dissection treated with antiplatelets versus anticoagulation. METHODS: This is a multicenter observational retrospective international study (16 countries, 63 sites) that included patients with cervical artery dissection without major trauma. The exposure was antithrombotic treatment type (anticoagulation versus antiplatelets), and outcomes were subsequent ischemic stroke and major hemorrhage (intracranial or extracranial hemorrhage). We used adjusted Cox regression with inverse probability of treatment weighting to determine associations between anticoagulation and study outcomes within 30 and 180 days. The main analysis used an as-Treated crossover approach and only included outcomes occurring with the above treatments. RESULTS: The study included 3636 patients (402 [11.1%] received exclusively anticoagulation and 2453 [67.5%] received exclusively antiplatelets). By day 180, there were 162 new ischemic strokes (4.4%) and 28 major hemorrhages (0.8%); 87.0% of ischemic strokes occurred by day 30. In adjusted Cox regression with inverse probability of treatment weighting, compared with antiplatelet therapy, anticoagulation was associated with a nonsignificantly lower risk of subsequent ischemic stroke by day 30 (adjusted hazard ratio [HR], 0.71 [95% CI, 0.45-1.12]; P=0.145) and by day 180 (adjusted HR, 0.80 [95% CI, 0.28-2.24]; P=0.670). Anticoagulation therapy was not associated with a higher risk of major hemorrhage by day 30 (adjusted HR, 1.39 [95% CI, 0.35-5.45]; P=0.637) but was by day 180 (adjusted HR, 5.56 [95% CI, 1.53-20.13]; P=0.009). In interaction analyses, patients with occlusive dissection had significantly lower ischemic stroke risk with anticoagulation (adjusted HR, 0.40 [95% CI, 0.18-0.88]; Pinteraction=0.009). CONCLUSIONS: Our study does not rule out the benefit of anticoagulation in reducing ischemic stroke risk, particularly in patients with occlusive dissection. If anticoagulation is chosen, it seems reasonable to switch to antiplatelet therapy before 180 days to lower the risk of major bleeding. Large prospective studies are needed to validate our findings. © 2024 Wolters Kluwer Health. All rights reserved.",
    title = "Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection: The STOP-CAD Study",
    doi = "10.1161/STROKEAHA.123.045731"
}