Factors Associated With Stroke Recurrence After Initial Diagnosis of Cervical Artery Dissection

Daniel M Mandel¹, Liqi Shu¹, Christopher Chang¹, Naomi Jack¹, Christopher R Leon Guerrero², Nils Henninger³, Jayachandra Muppa³, Muhammad Affan⁴, Omair Ul Haq Lodhi⁴, Mirjam R Heldner⁵, Kateryna Antonenko⁵, David Seiffge⁵, Marcel Arnold⁵, Setareh Salehi Omran⁶, Ross Crandall⁶, Evan Lester⁶, Diego Lopez Mena⁷, Antonio Arauz⁷, Ahmad Nehme⁸, Marion Boulanger⁸, Emmanuel Touzé⁸, Joao Andre Sousa⁹, Joao Sargento-Freitas⁹, Vasco Barata⁹, Paulo Castro-Chaves¹⁰, Maria Teresa Brito¹⁰, Muhib Khan^{11

12}, Dania Mallick¹¹, Aaron Rothstein¹³, Ossama Khazaal¹³, Josefin E Kaufman¹⁴, Stefan T Engelter¹⁴, Christopher Traenka¹⁴, Diana Aguiar de Sousa¹⁵, Mafalda Soares¹⁶, Sara Rosa¹⁷, Lily W Zhou¹⁸, Preet Gandhi¹⁸, Thalia S Field¹⁸, Steven Mancini¹⁸, Issa Metanis¹⁹, Ronen R Leker¹⁹, Kelly Pan¹, Vishnu Dantu¹, Karl Baumgartner¹, Tina Burton¹, Regina von Rennenberg²⁰, Christian H Nolte²⁰, Richard Choi²¹, Jason MacDonald²¹, Reza Bavarsad Shahripour²², Xiaofan Guo²³, Malik Ghannam²⁴, Mohammad Almajali²⁴, Edgar A Samaniego²⁴, Sebastian Sanchez²⁴, Bastien Rioux²⁵, Faycal Zine-Eddine²⁵, Alexandre Poppe²⁵, Ana Catarina Fonseca²⁶, Maria Fortuna Baptista²⁶, Diana Cruz²⁶, Michele Romoli²⁷, Giovanna De Marco²⁷, Marco Longoni²⁷, Zafer Keser¹², Kim Griffin¹², Lindsey Kuohn²⁸, Jennifer Frontera²⁸, Jordan Amar²⁹, James Giles²⁹, Marialuisa Zedde³⁰, Rosario Pascarella³¹, Ilaria Grisendi³⁰, Hipolito Nzwalo³², David S Liebeskind³³, Amir Molaie³³, Annie Cavalier³⁴, Wayneho Kam³⁵, Brian Mac Grory³⁴, Sami Al Kasab³⁶, Mohammad Anadani³⁶, Kimberly Kicielinski³⁷, Ali Eltatawy³⁸, Lina Chervak³⁸, Roberto Chulluncuy Rivas³⁸, Yasmin Aziz³⁸, Ekaterina Bakradze³⁹, Thanh Lam Tran³⁹, Marc Rodrigo Gisbert⁴⁰, Manuel Requena⁴⁰, Faddi Saleh Velez⁴¹, Jorge Ortiz Garcia⁴¹, Varsha Muddasani⁴², Adam de Havenon^{43

44}, Venugopalan Y Vishnu⁴⁵, Sridhara Yaddanapudi⁴⁶, Latasha Adams⁴⁶, Abigail Browngoehl⁴⁶, Tamra Ranasinghe⁴⁷, Randy Dunston⁴⁷, Zachary Lynch⁴⁷, Mary Penckofer⁴⁸, James E Siegler⁴⁸, Silvia Mayer⁴⁹, Joshua Willey⁴⁹, Adeel Zubair⁴³, Yee Kuang Cheng⁴³, Richa Sharma⁴³, João Pedro Marto⁵⁰, Vítor Mendes Ferreira⁵⁰, Piers Klein⁵¹, Thanh N Nguyen⁵¹, Syed Daniyal Asad⁵², Zoha Sarwat⁵², Anvesh Balabhadra⁵², Shivam Patel⁵², Thais Secchi⁵³, Sheila Martins^{53

54}, Gabriel Mantovani⁵⁴, Young Dae Kim⁵⁵, Balaji Krishnaiah⁵⁶, Cheran Elangovan⁵⁶, Sivani Lingam⁵⁷, Abid Y Qureshi⁵⁷, Sebastian Fridman⁵⁸, Alonso Alvarado-Bolanos⁵⁸, Farid Khasiyev⁵⁹, Guillermo Linares⁵⁹, Marina Mannino⁶⁰, Valeria Terruso⁶⁰, Sofia Vassilopoulou⁶¹, Vasileios Tentolouris-Piperas⁶¹, Manuel Martinez Marino⁶², Victor Carrasco Wall⁶², Fransisca Indraswari⁶³, Sleiman El Jamal⁶³, Shilin Liu⁶⁴, Muhammad Alvi⁶⁵, Farman Ali⁶⁵, Mohammed Sarvath⁶⁵, Rami Z Morsi⁶⁶, Tareq Kass-Hout⁶⁶, Feina Shi⁶⁷, Jinhua Zhang⁶⁷, Dilraj Sokhi⁶⁸, Jamil Said⁶⁸, Newnex Mongare⁶⁸, Alexis N Simpkins⁶⁹, Roberto Gomez⁶⁹, Shayak Sen⁶⁹, Mohammad Ghani⁷⁰, Marwa Elnazeir⁷⁰, Han Xiao⁷¹, Narendra Kala¹, Farhan Khan¹, Christoph Stretz¹, Nahid Mohammadzadeh¹, Eric Goldstein¹, Karen Furie¹, Shadi Yaghi¹

Affiliations

¹ Department of Neurology, Brown Medical School, Providence, RI (D.M.M., L.S., C.C., N.J., K.P., V.D., K.B., T.B., N.K., F. Khan, C.S., N. Mohammadzadeh, E.G., K.F., S. Yaghi).
² Department of Neurology, Atrium Health, Charlotte, NC (C.R.L.G.).
³ Department of Neurology, University of Massachusetts, Chan Medical School, Worcester, MA (N.H., J.M.).
⁴ Department of Neurology, University of Minnesota, Minneapolis (M. Affan, O.U.H.L.).
⁵ Department of Neurology, Inselspital, University of Bern, Switzerland (M.R.H., K.A., D. Seiffge, M. Arnold).
⁶ Department of Neurology, University of Colorado School of Medicine, Aurora (S.S.O., R. Crandall, E.L.).
⁷ Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Mexico (D.L.M., A. Arauz).
⁸ Service de Neurologie, CHU Caen-Normandie, Université Caen-Normandie, France (A.N., M.B., E.T.).
⁹ Department of Neurology, Coimbra University, Portugal (J.A.S., J.S.-F., V.B.).
¹⁰ Department of Internal Medicine, São João University Hospital, Portugal (P.C.-C., M.T.B.).
¹¹ Department of Neurology, Corewell Health, Grand Rapids, MI (M.K., D.M.).
¹² Department of Neurology, Mayo Clinic, Rochester, MN (M.K., Z.K., K.G.).
¹³ Department of Neurology, University of Pennsylvania, Philadelphia (A.R., O.K.).
¹⁴ Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, and University Hospital Basel, Switzerland (J.E.K., S.T.E., C.T.).
¹⁵ Stroke Center, Centro Hospitalar Universitário Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa, Portugal (D.A.d.S.).
¹⁶ Departments of Neurology (M. Soares), Centro Hospitalar Universitário Lisboa Central, Portugal.
¹⁷ Neuroradiology (S.R.), Centro Hospitalar Universitário Lisboa Central, Portugal.
¹⁸ Vancouver Stroke Program, Division of Neurology, University of British Columbia, Canada (L.W.Z., P.G., T.S.F., S. Mancini).
¹⁹ Department of Neurology, Hadassah-Hebrew University Medical Center, Israel (I.M., R.R.L.).
²⁰ Department of Neurology with Experimental Neurology, Charite Universitätsmedizin-Berlin and Center for Stroke Research, Germany (R.v.R., C.H.N.).
²¹ Department of Neurosciences, ChristianaCare, Newark, DE (R. Choi, J.M.).
²² Department of Neurology, University of California at San Diego (R.B.S.).
²³ Department of Neurology, Loma Linda University, CA (X.G.).
²⁴ Department of Neurology, University of Iowa (M. Ghannam, M. Almajali, E.A.S., S. Sanchez).
²⁵ Department of Neurosciences, Université de Montréal, Canada (B.R., F.Z.-E., A.P.).
²⁶ Department of Neurology, Hospital de Santa Maria, Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Portugal (A.C.F., M.F.B., D.C.).
²⁷ Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Italy (M. Romoli, G.D.M., M.L.).
²⁸ Department of Neurology, NYU Langone Health (L.K., J.F.).
²⁹ Department of Neurology, Washington University, Saint Louis, MO (J.A., J.G.).
³⁰ Neurology Unit, Stroke Unit (M.Z., I.G.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
³¹ Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
³² Department of Internal Medicine, Centro Hospital Universitario do Algarve, Faro, Portugal (H.N.).
³³ Department of Neurology, University of California at Los Angeles (D.S.L., A.M.).
³⁴ Department of Neurology, Duke University, Durham, NC (A.C., B.M.G.).
³⁵ Department of Neurology, University of North Carolina Health Rex, Raleigh (W.K.).
³⁶ Departments of Neurology (S.A.K., M. Anadani), Medical University of South Carolina, Charleston.
³⁷ Neurosurgery (K.K.), Medical University of South Carolina, Charleston.
³⁸ Department of Neurology, University of Cincinnati Medical Center, OH (A.E., L.C., R.C.R., Y.A.).
³⁹ Department of Neurology, University of Alabama at Birmingham (E.B., T.L.T.).
⁴⁰ Department of Neurology, University Hospital Vall d'Hebron, Barcelona, Spain (M.R.G., M. Requena).
⁴¹ Department of Neurology, University of Oklahoma (F.S.V., J.O.G.).
⁴² Department of Neurology, Einstein-Jefferson Healthcare Network, Philadelphia, PA (V.M.).
⁴³ Department of Neurology, Yale New Haven Hospital, CT (A.d.H., A.Z., Y.K.C., R.S.).
⁴⁴ Department of Neurology, University of Utah, Salt Lake City (A.d.H.).
⁴⁵ Department of Neurology, All India Medical School, New Delhi (V.Y.V.).
⁴⁶ Department of Neurology, Thomas Jefferson University, Philadelphia, PA (S. Yaddanapudi, L.A., A. Browngoehl).
⁴⁷ Department of Neurology, Wake Forest Medical Center, NC (T.R., R.D., Z.L.).
⁴⁸ Department of Neurology, Cooper University, Camden, NJ (M.P., J.E.S.).
⁴⁹ Department of Neurology, Columbia University Medical Center, New York (S. Mayer, J.W.).
⁵⁰ Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal (J.P.M., V.M.F.).
⁵¹ Department of Neurology, Boston Medical Center, MA (P.K., T.N.N.).
⁵² Department of Neurology, Hartford Hospital, CT (S.D.A., Z.S., A. Balabhadra, S.P.).
⁵³ Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil (S. Martins, T.S.).
⁵⁴ Department of Neurology, Hospital de Clínicas de Porto Alegre, Brazil (S. Martins, G.M.).
⁵⁵ Department of Neurology, Yonsei University, Seoul, South Korea (Y.D.K.).
⁵⁶ Department of Neurology, University of Tennessee at Memphis (B.K., C.E.).
⁵⁷ Department of Neurology, Kansas University Medical Center (S. Lingam, A.Y.Q.).
⁵⁸ Department of Neurology, Western Ontario University, London, Canada (S.F., A.A.-B.).
⁵⁹ Department of Neurology, Saint Louis University, MO (F. Khasiyev, G.L.).
⁶⁰ Department of Neurology and Stroke Unit, AOOR Villa Sofia-V. Cervello, Palermo, Italy (M.M., V.T.).
⁶¹ 1st Department of Neurology, National and Kapodistrian University of Athens, Greece (S.V., V.T.-P.).
⁶² Department of Neurology, Centro Médico Nacional Siglo XXI IMSS, Mexico (M.M.M., V.C.W.).
⁶³ Department of Neurology, The Miriam Hospital, Providence, RI (F.I., S.E.J.).
⁶⁴ Department of Neurocritical Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S. Liu).
⁶⁵ Department of Neurology, West Virginia University (M. Alvi, F.A., M. Sarvath).
⁶⁶ Department of Neurology, University of Chicago, IL (R.Z.M., T.K.-H.).
⁶⁷ Department of Neurology, Sir Run Run Shaw Hospital of Zhejiang University Medical School, Hangzhou, China (F.S., J.Z.).
⁶⁸ Department of Neurology, Aga Khan University, Nairobi, Kenya (D. Sokhi, J.S., N. Mongare).
⁶⁹ Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.N.S., R.G., S. Sen).
⁷⁰ Department of Neurology, University of Louisville (M. Ghani, M.E.).
⁷¹ Department of Economics, University of California Santa Barbara (H.X.).

PMID: 40143807
DOI: 10.1161/STROKEAHA.124.048215

Observational Study

Factors Associated With Stroke Recurrence After Initial Diagnosis of Cervical Artery Dissection

Daniel M Mandel et al. Stroke. 2025 Jun.

. 2025 Jun;56(6):1413-1421.

doi: 10.1161/STROKEAHA.124.048215. Epub 2025 Mar 27.

Authors

Affiliations

¹ Department of Neurology, Brown Medical School, Providence, RI (D.M.M., L.S., C.C., N.J., K.P., V.D., K.B., T.B., N.K., F. Khan, C.S., N. Mohammadzadeh, E.G., K.F., S. Yaghi).
² Department of Neurology, Atrium Health, Charlotte, NC (C.R.L.G.).
³ Department of Neurology, University of Massachusetts, Chan Medical School, Worcester, MA (N.H., J.M.).
⁴ Department of Neurology, University of Minnesota, Minneapolis (M. Affan, O.U.H.L.).
⁵ Department of Neurology, Inselspital, University of Bern, Switzerland (M.R.H., K.A., D. Seiffge, M. Arnold).
⁶ Department of Neurology, University of Colorado School of Medicine, Aurora (S.S.O., R. Crandall, E.L.).
⁷ Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Mexico (D.L.M., A. Arauz).
⁸ Service de Neurologie, CHU Caen-Normandie, Université Caen-Normandie, France (A.N., M.B., E.T.).
⁹ Department of Neurology, Coimbra University, Portugal (J.A.S., J.S.-F., V.B.).
¹⁰ Department of Internal Medicine, São João University Hospital, Portugal (P.C.-C., M.T.B.).
¹¹ Department of Neurology, Corewell Health, Grand Rapids, MI (M.K., D.M.).
¹² Department of Neurology, Mayo Clinic, Rochester, MN (M.K., Z.K., K.G.).
¹³ Department of Neurology, University of Pennsylvania, Philadelphia (A.R., O.K.).
¹⁴ Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, and University Hospital Basel, Switzerland (J.E.K., S.T.E., C.T.).
¹⁵ Stroke Center, Centro Hospitalar Universitário Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa, Portugal (D.A.d.S.).
¹⁶ Departments of Neurology (M. Soares), Centro Hospitalar Universitário Lisboa Central, Portugal.
¹⁷ Neuroradiology (S.R.), Centro Hospitalar Universitário Lisboa Central, Portugal.
¹⁸ Vancouver Stroke Program, Division of Neurology, University of British Columbia, Canada (L.W.Z., P.G., T.S.F., S. Mancini).
¹⁹ Department of Neurology, Hadassah-Hebrew University Medical Center, Israel (I.M., R.R.L.).
²⁰ Department of Neurology with Experimental Neurology, Charite Universitätsmedizin-Berlin and Center for Stroke Research, Germany (R.v.R., C.H.N.).
²¹ Department of Neurosciences, ChristianaCare, Newark, DE (R. Choi, J.M.).
²² Department of Neurology, University of California at San Diego (R.B.S.).
²³ Department of Neurology, Loma Linda University, CA (X.G.).
²⁴ Department of Neurology, University of Iowa (M. Ghannam, M. Almajali, E.A.S., S. Sanchez).
²⁵ Department of Neurosciences, Université de Montréal, Canada (B.R., F.Z.-E., A.P.).
²⁶ Department of Neurology, Hospital de Santa Maria, Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Portugal (A.C.F., M.F.B., D.C.).
²⁷ Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Italy (M. Romoli, G.D.M., M.L.).
²⁸ Department of Neurology, NYU Langone Health (L.K., J.F.).
²⁹ Department of Neurology, Washington University, Saint Louis, MO (J.A., J.G.).
³⁰ Neurology Unit, Stroke Unit (M.Z., I.G.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
³¹ Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
³² Department of Internal Medicine, Centro Hospital Universitario do Algarve, Faro, Portugal (H.N.).
³³ Department of Neurology, University of California at Los Angeles (D.S.L., A.M.).
³⁴ Department of Neurology, Duke University, Durham, NC (A.C., B.M.G.).
³⁵ Department of Neurology, University of North Carolina Health Rex, Raleigh (W.K.).
³⁶ Departments of Neurology (S.A.K., M. Anadani), Medical University of South Carolina, Charleston.
³⁷ Neurosurgery (K.K.), Medical University of South Carolina, Charleston.
³⁸ Department of Neurology, University of Cincinnati Medical Center, OH (A.E., L.C., R.C.R., Y.A.).
³⁹ Department of Neurology, University of Alabama at Birmingham (E.B., T.L.T.).
⁴⁰ Department of Neurology, University Hospital Vall d'Hebron, Barcelona, Spain (M.R.G., M. Requena).
⁴¹ Department of Neurology, University of Oklahoma (F.S.V., J.O.G.).
⁴² Department of Neurology, Einstein-Jefferson Healthcare Network, Philadelphia, PA (V.M.).
⁴³ Department of Neurology, Yale New Haven Hospital, CT (A.d.H., A.Z., Y.K.C., R.S.).
⁴⁴ Department of Neurology, University of Utah, Salt Lake City (A.d.H.).
⁴⁵ Department of Neurology, All India Medical School, New Delhi (V.Y.V.).
⁴⁶ Department of Neurology, Thomas Jefferson University, Philadelphia, PA (S. Yaddanapudi, L.A., A. Browngoehl).
⁴⁷ Department of Neurology, Wake Forest Medical Center, NC (T.R., R.D., Z.L.).
⁴⁸ Department of Neurology, Cooper University, Camden, NJ (M.P., J.E.S.).
⁴⁹ Department of Neurology, Columbia University Medical Center, New York (S. Mayer, J.W.).
⁵⁰ Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal (J.P.M., V.M.F.).
⁵¹ Department of Neurology, Boston Medical Center, MA (P.K., T.N.N.).
⁵² Department of Neurology, Hartford Hospital, CT (S.D.A., Z.S., A. Balabhadra, S.P.).
⁵³ Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil (S. Martins, T.S.).
⁵⁴ Department of Neurology, Hospital de Clínicas de Porto Alegre, Brazil (S. Martins, G.M.).
⁵⁵ Department of Neurology, Yonsei University, Seoul, South Korea (Y.D.K.).
⁵⁶ Department of Neurology, University of Tennessee at Memphis (B.K., C.E.).
⁵⁷ Department of Neurology, Kansas University Medical Center (S. Lingam, A.Y.Q.).
⁵⁸ Department of Neurology, Western Ontario University, London, Canada (S.F., A.A.-B.).
⁵⁹ Department of Neurology, Saint Louis University, MO (F. Khasiyev, G.L.).
⁶⁰ Department of Neurology and Stroke Unit, AOOR Villa Sofia-V. Cervello, Palermo, Italy (M.M., V.T.).
⁶¹ 1st Department of Neurology, National and Kapodistrian University of Athens, Greece (S.V., V.T.-P.).
⁶² Department of Neurology, Centro Médico Nacional Siglo XXI IMSS, Mexico (M.M.M., V.C.W.).
⁶³ Department of Neurology, The Miriam Hospital, Providence, RI (F.I., S.E.J.).
⁶⁴ Department of Neurocritical Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S. Liu).
⁶⁵ Department of Neurology, West Virginia University (M. Alvi, F.A., M. Sarvath).
⁶⁶ Department of Neurology, University of Chicago, IL (R.Z.M., T.K.-H.).
⁶⁷ Department of Neurology, Sir Run Run Shaw Hospital of Zhejiang University Medical School, Hangzhou, China (F.S., J.Z.).
⁶⁸ Department of Neurology, Aga Khan University, Nairobi, Kenya (D. Sokhi, J.S., N. Mongare).
⁶⁹ Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.N.S., R.G., S. Sen).
⁷⁰ Department of Neurology, University of Louisville (M. Ghani, M.E.).
⁷¹ Department of Economics, University of California Santa Barbara (H.X.).

PMID: 40143807
DOI: 10.1161/STROKEAHA.124.048215

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.

Keywords: arteries; fibrinolytic agents; infarction; ischemic stroke; platelet aggregation inhibitors.

PubMed Disclaimer

Conflict of interest statement

Dr Heldner reports grants from Swiss National Science Foundation, Swiss Heart Foundation, and SITEM Research Funds. Dr Antonenko reports grants from Swiss National Science Foundation. Dr Seiffge reports grants from AstraZeneca and compensation from AstraZeneca for consultant services. Dr Arnold reports compensation from Novo Nordisk; Covidien, Medtronic; Amgen; AstraZeneca, Bayer, Bristol Myers Squibb, Covidien, Daiichi Sankyo, Novartis, Sanofi, Pfizer; and Boehringer Ingelheim for consultant services. Dr Touzé reports employment by Caen and compensation from Elsevier for other services. Dr M. Khan reports compensation from Fred Hutchinson Cancer Research Center for end point review committee services and grants from Mayo Foundation for Medical Education and Research. Dr Rothstein reports grants from American Heart Association. Dr Rosa reports grants from Merck Sharp and Dohme Corporation. Dr Field reports compensation from Bayer for consultant services, HLS Therapeutics, AstraZeneca Canada, and Novartis for consultant services; service as Board Member for Destine Health; and compensation from Canadian Medical Protective Association for expert witness services. Dr Poppe reports compensation from Roche for other services; grants from Heart and Stroke Foundation of Canada, Foundation Brain Canada, Canadian Institutes of Health Research, and Stryker. Dr Aguiar de Sousa reports compensation from AstraZeneca, Bayer, Daiichi Sankyo, Fundação Bial, Johnson and Johnson, for other services, compensation from Organon & Co. for consultant services, compensation from University of British Columbia for Data and Safety Monitoring services. Dr Liebeskind reports compensation from Cerenovus, Genentech, Medtronic, Stryker, and Rapid Medical Ltd for consultant services. Dr Mac Grory reports grants from Duke Bass Connections, National Institutes of Health, American Heart Association, and Duke Office of Physician Scientist Development; and employment by Duke University Medical Center. Dr Kicielinski reports employment by Medical University of South Carolina and Elsevier; and compensation from Penumbra Inc for other services. Dr Siegler reports compensation from AstraZeneca for other services; employment by Cooper Hospital and University of Chicago; grants from Viz.ai; grants from Philips. Dr Sharma reports grants from the National Institutes of Health Clinical Center and a provisional patent has filed a provisional patent for a stroke etiology classifier algorithm. Dr Martins reports compensation from Boehringer Ingelheim, Penumbra Inc, Novartis, Novo Nordisk, Medtronic, Bayer, Daiichi Sankyo Company; AstraZeneca, Servier Affaires Medicales, and Pfizer for other services. Dr Sokhi reports compensation from F. Hoffmann-La Roche for other services. Dr Simpkins reports compensation from National Institute of Neurological Disorders and Stroke for data and safety monitoring services; compensation from Up to Date for other services; and grants from National Institutes of Health. Dr Stretz has received funding from Massachusetts General Hospital/BSC and Duke University Medical Center/National Institutes of Health (302000478/5K23HL161426- 02), and receives funding from the American Heart Association (24SCVNCFRE1301274). Dr Furie reports compensation from Janssen Biotech for consultant services. The other authors report no conflicts.

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Factors Associated With Stroke Recurrence After Initial Diagnosis of Cervical Artery Dissection

Affiliations

Factors Associated With Stroke Recurrence After Initial Diagnosis of Cervical Artery Dissection

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

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LinkOut - more resources

Full Text Sources

Medical

Miscellaneous