Mandel, Daniel MDaniel MMandelShu, LiqiLiqiShuChang, ChristopherChristopherChangJack, NaomiNaomiJackLeon Guerrero, Christopher RChristopher RLeon GuerreroHenninger, NilsNilsHenningerMuppa, JayachandraJayachandraMuppaAffan, MuhammadMuhammadAffanUl Haq Lodhi, OmairOmairUl Haq LodhiHeldner, Mirjam R.Mirjam R.Heldner0000-0002-3594-2159Antonenko, KaterynaKaterynaAntonenkoSeiffge, DavidDavidSeiffgeArnold, MarcelMarcelArnoldSalehi Omran, SetarehSetarehSalehi OmranCrandall, RossRossCrandallLester, EvanEvanLesterLopez Mena, DiegoDiegoLopez MenaArauz, AntonioAntonioArauzNehme, AhmadAhmadNehmeBoulanger, MarionMarionBoulangerTouze, EmmanuelEmmanuelTouzeSousa, Joao AndreJoao AndreSousaSargento-Freitas, JoaoJoaoSargento-FreitasBarata, VascoVascoBarataCastro-Chaves, PauloPauloCastro-ChavesBrito, Maria TeresaMaria TeresaBritoKhan, MuhibMuhibKhanMallick, DaniaDaniaMallickRothstein, AaronAaronRothsteinKhazaal, OssamaOssamaKhazaalKaufman, Josefin EJosefin EKaufmanEngelter, Stefan TStefan TEngelterTraenka, ChristopherChristopherTraenkaAguiar de Sousa, DianaDianaAguiar de SousaSoares, MafaldaMafaldaSoaresRosa, SaraSaraRosaZhou, Lily WLily WZhouGandhi, PreetPreetGandhiField, Thalia SThalia SFieldMancini, StevenStevenManciniMetanis, IssaIssaMetanisLeker, Ronen RRonen RLekerPan, KellyKellyPanDantu, VishnuVishnuDantuBaumgartner, KarlKarlBaumgartnerBurton, TinaTinaBurtonvon Rennenberg, ReginaReginavon RennenbergNolte, Christian HChristian HNolteChoi, RichardRichardChoiMacDonald, JasonJasonMacDonaldBavarsad Shahripour, RezaRezaBavarsad ShahripourGuo, XiaofanXiaofanGuoGhannam, MalikMalikGhannamAlmajali, MohammadMohammadAlmajaliSamaniego, Edgar AEdgar ASamaniegoSanchez, SebastianSebastianSanchezRioux, BastienBastienRiouxZine-Eddine, FaycalFaycalZine-EddinePoppe, AlexandreAlexandrePoppeFonseca, Ana CatarinaAna CatarinaFonsecaFortuna Baptista, MariaMariaFortuna BaptistaCruz, DianaDianaCruzRomoli, MicheleMicheleRomoliDe Marco, GiovannaGiovannaDe MarcoLongoni, MarcoMarcoLongoniKeser, ZaferZaferKeserGriffin, KimKimGriffinKuohn, LindseyLindseyKuohnFrontera, JenniferJenniferFronteraAmar, JordanJordanAmarGiles, JamesJamesGilesZedde, MarialuisaMarialuisaZeddePascarella, RosarioRosarioPascarellaGrisendi, IlariaIlariaGrisendiNzwalo, HipolitoHipolitoNzwaloLiebeskind, David SDavid SLiebeskindMolaie, AmirAmirMolaieCavalier, AnnieAnnieCavalierKam, WaynehoWaynehoKamMac Grory, BrianBrianMac GroryAl Kasab, SamiSamiAl KasabAnadani, MohammadMohammadAnadaniKicielinski, KimberlyKimberlyKicielinskiEltatawy, AliAliEltatawyChervak, LinaLinaChervakChulluncuy Rivas, RobertoRobertoChulluncuy RivasAziz, YasminYasminAzizBakradze, EkaterinaEkaterinaBakradzeTran, Thanh LamThanh LamTranRodrigo Gisbert, MarcMarcRodrigo GisbertRequena, ManuelManuelRequenaSaleh Velez, FaddiFaddiSaleh VelezOrtiz Gracia, JorgeJorgeOrtiz GraciaMuddasani, VarshaVarshaMuddasanide Havenon, AdamAdamde HavenonVishnu, Venugopalan YVenugopalan YVishnuYaddanapudi, SridharaSridharaYaddanapudiAdams, LatashaLatashaAdamsBrowngoehl, AbigailAbigailBrowngoehlRanasinghe, TamraTamraRanasingheDunston, RandyRandyDunstonLynch, ZacharyZacharyLynchPenckofer, MaryMaryPenckoferSiegler, James EJames ESieglerMayer, SilviaSilviaMayerWilley, JoshuaJoshuaWilleyZubair, AdeelAdeelZubairCheng, Yee KuangYee KuangChengSharma, RichaRichaSharmaMarto, João PedroJoão PedroMartoMendes Ferreira, VítorVítorMendes FerreiraKlein, PiersPiersKleinNguyen, Thanh NThanh NNguyenAsad, Syed DaniyalSyed DaniyalAsadSarwat, ZohaZohaSarwatBalabhadra, AnveshAnveshBalabhadraPatel, ShivamShivamPatelSecchi, ThaisThaisSecchiMartins, SheilaSheilaMartinsMantovani, GabrielGabrielMantovaniKim, Young DaeYoung DaeKimKrishnaiah, BalajiBalajiKrishnaiahElangovan, CheranCheranElangovanLingam, SivaniSivaniLingamQuereshi, AbidAbidQuereshiFridman, SebastianSebastianFridmanAlvarado, AlonsoAlonsoAlvaradoKhasiyev, FaridFaridKhasiyevLinares, GuillermoGuillermoLinaresMannino, MarinaMarinaManninoTerruso, ValeriaValeriaTerrusoVassilopoulou, SofiaSofiaVassilopoulouTentolouris-Piperas, VasileiosVasileiosTentolouris-PiperasMartinez Marino, ManuelManuelMartinez MarinoCarrasco Wall, VictorVictorCarrasco WallIndraswari, FransiscaFransiscaIndraswariEl Jamal, SleimanSleimanEl JamalLiu, ShilinShilinLiuAlvi, MuhammadMuhammadAlviAli, FarmanFarmanAliSarvath, MohammedMohammedSarvathMorsi, Rami ZRami ZMorsiKass-Hout, TareqTareqKass-HoutShi, FeinaFeinaShiZhang, JinhuaJinhuaZhangSokhi, DilrajDilrajSokhiSaid, JamilJamilSaidMongare, NewnexNewnexMongareSimpkins, AlexisAlexisSimpkinsGomez, RobertoRobertoGomezSen, ShayakShayakSenGhani, MohammadMohammadGhaniElnazeir, MarwaMarwaElnazeirXiao, HanHanXiaoKala, NarendraNarendraKalaKhan, FarhanFarhanKhanStretz, ChristophChristophStretzMohammadzadeh, NahidNahidMohammadzadehGoldstein, EricEricGoldsteinFurie, KarenKarenFurieYaghi, ShadiShadiYaghi2025-04-222025-04-222025-03-27https://boris-portal.unibe.ch/handle/20.500.12422/208877Background 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.enarteriesfibrinolytic agentsinfarctionischemic strokeplatelet aggregation inhibitors600 - Technology::610 - Medicine & healtharticle10.48620/874384014380710.1161/STROKEAHA.124.048215