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No Significant Difference Between Anticoagulants, Antiplatelets in Preventing Events After Cervical Artery Dissection
Anticoagulation therapy in patients with cervical artery dissection was associated with a lower combined rate of 90-day ischemic stroke, major bleeding, or death compared with antiplatelet therapy, although the difference was not statistically significant. Researchers published the results from their systematic review and individual patient data meta-analysis online in JAMA Neurology.
The meta-analysis spanned 444 patients from 2 randomized clinical trials: the Cervical Artery Dissection in Stroke Study and the Biomarkers and Antithrombotic Treatment in Cervical Artery Dissection trial. The primary outcome was a composite of ischemic stroke, death, or major extracranial or intracranial bleeding at 90 days of follow-up. The composite components of stroke, death, and major bleeding were each secondary outcomes.
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According to the findings, primary end point rates were 1.4% in patients randomized to anticoagulation therapy and 4.4% in patients randomized to antiplatelet therapy. Researchers reported a 0.33 odds ratio of a primary end point with anticoagulation therapy compared with antiplatelet therapy, but they noted that the statistical difference between the 2 therapies was not significant.
Rates of stroke were 0.5% with anticoagulation compared with 4.0% with aspirin. Bleeding events, however, were higher with anticoagulation than aspirin: 2 events vs 0 events.
“The findings of this meta-analysis found no significant difference between anticoagulants and antiplatelets in preventing early recurrent events,” concluded first author Josefin E. Kaufmann, MMed, of University Hospital Basel and University of Basel in Switzerland, and study coauthors.
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