SynthesisPloS one2013
Antiplatelets versus anticoagulants for the treatment of cervical artery dissection: Bayesian meta-analysis.
Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Antiplatelets Versus Anticoagulation in Cervical Artery Dissection: A Systematic Review and Meta-analysis of 2064 Patients.Drugs in R&D · 2022Pooled it
- Surgical and radiological interventions for treating symptomatic extracranial cervical artery dissection.The Cochrane database of systematic reviews · 2021Pooled it
- Antiplatelet vs. Anticoagulation in Cervical Artery Dissection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Frontiers in neurology · 2021Pooled it
- Antiplatelets or anticoagulants? Secondary prevention in cervical artery dissection: an updated meta-analysis.Neurological research and practice · 2022Review
- Stroke Prevention in Cervical Artery Dissection.Current cardiology reports · 2021Review
- Combined Anticoagulation and Antiaggregation in Acute Cervical Artery Dissection.Journal of clinical medicine · 2021Article
- Postpartum Acute Basilar Artery Occlusion Secondary to Vertebral Artery Dissection. Case Report and Literature Review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2021Article
- ESO guideline for the management of extracranial and intracranial artery dissection.European stroke journal · 2021Article
- Systematic review of the effectiveness of carotid surgery and endovascular carotid stenting versus best medical treatment in managing symptomatic acute carotid artery dissection.Annals of translational medicine · 2021Review
- Cervical and intracranial artery dissections.Therapeutic advances in neurological disorders · 2021Review
- Biomarkers and antithrombotic treatment in cervical artery dissection - Design of the TREAT-CAD randomised trial.European stroke journal · 2020Article
- Novel Oral Anticoagulants as Treatment for Vertebral Artery Dissection: Case Report.Journal of vascular and interventional neurology · 2018Article
- Dissection of Cervical and Cerebral Arteries.Current neurology and neuroscience reports · 2017Review
- Treatment of Cervical Artery Dissection: Antithrombotics, Thrombolysis, and Endovascular Therapy.BioMed research international · 2017Review
- Horner's Syndrome due to a Spontaneous Internal Carotid Artery Dissection after Deep Sea Scuba Diving.Case reports in neurological medicine · 2016Article
- Helsinki experience on nonvitamin K oral anticoagulants for treating cervical artery dissection.Brain and behavior · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the effects of antiplatelets and anticoagulants on stroke and death in patients with acute cervical artery dissection.
designSystematic review with Bayesian meta-analysis. DATA SOURCES: The reviewers searched MEDLINE and EMBASE from inception to November 2012, checked reference lists, and contacted authors. STUDY SELECTION: Studies were eligible if they were randomised, quasi-randomised or observational comparisons of antiplatelets and anticoagulants in patients with cervical artery dissection. DATA EXTRACTION: Data were extracted by one reviewer and checked by another. Bayesian techniques were used to appropriately account for studies with scarce event data and imbalances in the size of comparison groups. DATA SYNTHESIS: Thirty-seven studies (1991 patients) were included. We found no randomised trial. The primary analysis revealed a large treatment effect in favour of antiplatelets for preventing the primary composite outcome of ischaemic stroke, intracranial haemorrhage or death within the first 3 months after treatment initiation (relative risk 0.32, 95% credibility interval 0.12 to 0.63), while the degree of between-study heterogeneity was moderate (τ(2) = 0.18). In an analysis restricted to studies of higher methodological quality, the possible advantage of antiplatelets over anticoagulants was less obvious than in the main analysis (relative risk 0.73, 95% credibility interval 0.17 to 2.30).
conclusionIn view of these results and the safety advantages, easier usage and lower cost of antiplatelets, we conclude that antiplatelets should be given precedence over anticoagulants as a first line treatment in patients with cervical artery dissection unless results of an adequately powered randomised trial suggest the opposite.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.