Evidence map›Paper›PMID 41573419›Full record

ArticleStroke (Hoboken, N.J.)2025

Antithrombotic Trends Before and After Publication of Randomized Clinical Trials in Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study.

Mary Penckofer, Liqi Shu, Lukas Strelecky, Shadi Yaghi, Nils Henninger, Jayachandra Muppa, Ekaterina Bakradze, Mirjam R Heldner, Kateryna Antonenko, Setareh Salehi Omran and 14 more

Abstract read
In one paragraph

Article in Stroke (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Mary PenckoferCooper Medical School of Rowan University Camden NJ.
Liqi ShuDepartment of Neurology The Warren Alpert Medical School of Brown University, Brown Medical School Providence RI.
Lukas StreleckyDepartment of Neurology Brown University Providence RI.
Shadi YaghiDepartment of Neurology The Warren Alpert Medical School of Brown University, Brown Medical School Providence RI.
Nils HenningerDepartment of Neurology University of Massachusetts, Chan Medical School Worcester MA.
Jayachandra MuppaDepartment of Neurology University of Massachusetts, Chan Medical School Worcester MA.
Ekaterina BakradzeDepartment of Neurology University of Alabama at Birmingham Birmingham AL.
Mirjam R HeldnerDepartment of Neurology Inselspital, University of Bern Bern Switzerland.
Kateryna AntonenkoDepartment of Neurology Inselspital, University of Bern Bern Switzerland.
Setareh Salehi OmranDepartment of Neurology University of Colorado Aurora CO.
David J SeiffgeDepartment of Neurology Inselspital, University of Bern Bern Switzerland.
Marcel ArnoldDepartment of Neurology Inselspital, University of Bern Bern Switzerland.
Marialuisa ZeddeNeurology Unit, Stroke Unit Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Reggio Emilia Italy.
Adeel ZubairDepartment of Neurology Yale New Haven Hospital New Haven CT USA.
João Pedro MartoDepartment of Neurology Hospital de Egas Moniz Centro Hospitalar Lisboa Ocidental Lisbon Portugal.
Malik GhannamDepartment of Neurology University of Iowa Iowa City IA.
Stefan EngelterDepartment of Neurology, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research University of Basel Basel Switzerland.
Christopher TraenkaDepartment of Neurology, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research University of Basel Basel Switzerland.
Brian Mac GroryDepartment of Neurology Duke University School of Medicine Durham NC.
Wayneho KamComprehensive Stroke Center University of North Carolina Health Rex Raleigh NC.
Marwa ElnazeirDepartment of Neurology University of Louisville Louisville KY.
Michele RomoliNeurology and Stroke Unit, Department of Neuroscience Bufalini Hospital Cesena Italy.
Faddi G Saleh VelezDepartment of Neurology University of Oklahoma Health Sciences Center Oklahoma City OK.
James E SieglerDepartment of Neurology University of Chicago Chicago IL.ORCID https://orcid.org/0000-0003-0287-3967

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Two randomized clinical trials have failed to demonstrate the superiority of anticoagulation over antiplatelet therapy in acute cervical artery dissection, with many patients still receiving anticoagulation despite bleeding risks. In this analysis, we assessed temporal changes in antithrombotic strategies of cervical artery dissection following publication of these 2 trials. Methods: This is a secondary analysis of a retrospective multinational observational cohort study evaluating outcomes related to antithrombotic treatment for acute cervical artery dissection (January 2015-December 2022). The odds of oral anticoagulant use (over single or combination antiplatelet) therapy across each year were estimated using multivariable logistic regression and joinpoint regression. Least absolute shrinkage and selection operator-adjusted regression was used to assess the odds of anticoagulation each year following 2016. Results: Among 3345 included patients, 862 (25.8%) were treated with anticoagulation (n = 436 treated with anticoagulation and antiplatelet therapy). Nearly half (45.1%) were female with a median age of 46 years (interquartile range, 37-56). Compared with patients treated in 2015, those treated in subsequent years showed a stepwise decrease in treatment with any oral anticoagulation (odds ratio [OR] 0.91, 95% CI: 0.87-0.94). Independent predictors of increased anticoagulant use included female sex (adjusted OR [aOR] 1.22, 95% CI: 1.03-1.46), presence of infarct on imaging (aOR 1.45, 95% CI: 1.19-1.77), and partially occlusive thrombus (aOR 3.09, 95% CI: 2.38-4.01). Meanwhile, independent predictors of decreased anticoagulant use included lower baseline National Institutes of Health Stroke Scale score (aOR 0.95, 95% CI 0.93-0.97) and single vertebral artery involvement (aOR 0.63, 95% CI: 0.52-0.76). Meanwhile, independent predictors of decreased anticoagulant use included lower baseline National Institutes of Health Stroke Scale score (aOR 0.95, 95% CI: 0.93-0.97) and single vertebral artery involvement (aOR 0.63, 95% CI: 0.52-0.76). Each year following 2016 was associated with a lower rate of anticoagulation (average annualized percent change -13.91%, 95% CI: -18.73% to -9.10%). In 2021, there was a significant difference in the monthly rate of decline of anticoagulation use when compared with preceding years ( Conclusion: These real-world clinical practice data indicate a decline in the use and duration of oral anticoagulation for acute cervical artery dissection.

Indexed as

antithromboticepidemiologyvervical artery dissection

Identifiers

PMID41573419
PMCPMC12697651

What OpenQuestion holds

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Registered trials

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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.