@article{uoadl:3495156,
    journal = "ISRN Stroke",
    issn = "2090-9454",
    BIBTEX_ENTRY = "article",
    year = "2025",
    author = "Mandel, Daniel M. and Shu, Liqi and Chang, Christopher and Jack, Naomi 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 Kaufman, 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 Fortuna Baptista, Maria 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 Muddasani, 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 E. 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-Piperas, Vasileios 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 Mongare, Newnex and Simpkins, Alexis 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 and Yaghi, Shadi",
    abstract = "BACKGROUND: Patients presenting with cervical artery dissection (CAD) are at risk for subsequent ischemic events. We aimed to identify characteristics that are associated with increased risk of ischemic stroke after initial presentation of CAD and to evaluate the differential impact of anticoagulant versus antiplatelet therapy in these high-risk individuals. METHODS: This was a preplanned secondary analysis of the STOP-CAD study (Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection), a multicenter international retrospective observational study (63 sites from 16 countries in North America, South America, Europe, Asia, and Africa) that included patients with CAD predominantly between January 2015 and June 2022. The primary outcome was subsequent ischemic stroke by day 180 after diagnosis. Clinical and imaging variables were compared between those with versus without subsequent ischemic stroke. Significant factors associated with subsequent stroke risk were identified using stepwise Cox regression. Associations between subsequent ischemic stroke risk and antithrombotic therapy type (anticoagulation versus antiplatelets) among patients with identified risk factors were explored using adjusted Cox regression. RESULTS: In all, 4023 patients (mean age was 47.4 years; 44.5% were women) were included. By day 180, subsequent ischemic stroke occurred in 5.3% of the cohort. In adjusted Cox regression, factors associated with increased risk of subsequent ischemic stroke were prior history of ischemic stroke (adjusted hazard ratio [aHR], 7.31 [95% CI, 1.61-33.13]; P=0.010), presentation within 7 days from first symptoms (aHR, 3.04 [95% CI, 1.04-8.91]; P=0.043), infarct on baseline imaging (aHR, 9.85 [95% CI, 3.65-26.58]; P<0.001), and occlusive dissection (aHR, 2.34 [95% CI, 1.03-5.34]; P=0.043). Only patients with occlusive dissection demonstrated a reduced risk of subsequent ischemic stroke when treated with anticoagulation versus antiplatelets (aHR, 0.36 [95% CI, 0.16-0.80]; P=0.01). CONCLUSIONS: In this post hoc analysis of the STOP-CAD study, several factors associated with subsequent ischemic stroke were identified among patients with CAD. Furthermore, we identified a potential benefit of anticoagulation in patients with CAD with occlusive dissection. These findings require validation by meta-analyses of prior studies to formulate optimal treatment strategies for specific high-risk CAD subgroups. © 2025 American Heart Association, Inc.",
    title = "Factors Associated With Stroke Recurrence After Initial Diagnosis of Cervical Artery Dissection",
    doi = "10.1161/STROKEAHA.124.048215"
}