COMPARATIVE STUDY
CONTROLLED CLINICAL TRIAL
JOURNAL ARTICLE
META-ANALYSIS
RESEARCH SUPPORT, NON-U.S. GOV'T
SYSTEMATIC REVIEW
Add like
Add dislike
Add to saved papers

Antiplatelets vs anticoagulation for dissection: CADISS nonrandomized arm and meta-analysis.

Neurology 2012 August 15
OBJECTIVE: To present the results of the nonrandomized arm of the Cervical Artery Dissection in Stroke Study (CADISS-NR) trial, comparing anticoagulation and antiplatelets for prevention of recurrent stroke after carotid and vertebral dissection, and perform a meta-analysis of these results with previously published studies comparing the 2 therapeutic strategies.

METHODS: A total of 88 patients from 22 centers with extracranial carotid and vertebral dissection were recruited within 1 month of symptom onset. The primary endpoint was recurrent stroke at 3 months. A systematic review was performed, and results of published studies included in a meta-analysis with the CADISS-NR results.

RESULTS: In CADISS-NR, one patient in each group had recurrent ischemic stroke (antiplatelet 1/59 [1.69% ], anticoagulation 1/28 [3.57%]). At the primary endpoint of 3 months, 3 (5.08%) antiplatelet patients had recurrent TIA, compared with none in the anticoagulation group. For meta-analysis, there were data from 40 nonrandomized studies including 1,636 patients. There was no significant difference between the 2 treatments in recurrent stroke risk (antiplatelet 13/499 [2.6%], anticoagulant 20/1,137 [1.8%], odds ratio [OR] 1.49) or risk of death (antiplatelet 5/499 [1.00%], anticoagulant 9/1,137 [0.80%], OR 1.27).

CONCLUSION: There is no evidence for superiority of anticoagulation or antiplatelet therapy in prevention of stoke after carotid and vertebral artery dissection; however, all data are from nonrandomized studies and randomized studies are required. The nonrandomized CADISS data show a lower rate of recurrent stroke than reported in some previous studies.

CLINICAL TRIAL REGISTRATION INFORMATION: www.dissection.co.uk, ISRNCTN44555237.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app