Aspirin vs anticoagulation in carotid artery dissection: a study of 298 patients

Détails

ID Serval
serval:BIB_F45D07730C16
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Aspirin vs anticoagulation in carotid artery dissection: a study of 298 patients
Périodique
Neurology
Auteur⸱e⸱s
Georgiadis Dimitrios, Arnold Marcel, von Buedingen H.-Christian , Valko  P., Sarikaya Hakan, Rousson Valentin, Mattle Heinrich, Bousser Marie-Germaine, Baumgartner Ralf W.
ISSN
1526-632X[electronic]
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
72
Numéro
21
Pages
1810-1815
Langue
anglais
Résumé
BACKGROUND: No randomized study has yet compared efficacy and safety of aspirin and anticoagulants in patients with spontaneous dissection of the cervical carotid artery (sICAD). METHODS: Prospectively collected data from 298 consecutive patients with sICAD (56% men; mean age 46 +/- 10 years) treated with anticoagulants alone (n = 202) or aspirin alone (n = 96) were retrospectively analyzed. Admission diagnosis was ischemic stroke in 165, TIA in 37, retinal ischemia in 8, and local symptoms and signs (headache, neck pain, Horner syndrome, cranial nerve palsy) in 80 patients, while 8 patients were asymptomatic. Clinical follow-up was obtained after 3 months by neurologic examination (97% of patients) or structured telephone interview. Outcome measures were 1) new cerebral ischemic events, defined as ischemic stroke, TIA, or retinal ischemia, 2) symptomatic intracranial hemorrhage, and 3) major extracranial bleeding. RESULTS: During follow-up, ischemic events were rare (ischemic stroke, 0.3%; TIA, 3.4%; retinal ischemia, 1%); their frequency did not significantly differ between patients treated with anticoagulants (5.9%) and those treated with aspirin (2.1%). The same was true for hemorrhagic adverse events (anticoagulants, 2%; aspirin, 1%). New ischemic events were significantly more frequent in patients with ischemic events at onset (6.2%) than in patients with local symptoms or asymptomatic patients (1.1%). CONCLUSIONS: Within the limitations of a nonrandomized study, our data suggest that frequency of new cerebral and retinal ischemic events in patients with spontaneous dissection of the cervical carotid artery is low and probably independent of the type of antithrombotic treatment (aspirin or anticoagulants).
Mots-clé
Anticoagulants/therapeutic use, Aspirin/therapeutic use, Brain Ischemia/etiology, Brain Ischemia/prevention & control, Carotid Artery, Internal, Dissection/complications, Carotid Artery, Internal, Dissection/drug therapy, Female, Follow-Up Studies, Humans, Intracranial Hemorrhages/etiology, Intracranial Hemorrhages/prevention & control, Ischemia/etiology, Ischemia/prevention & control, Ischemic Attack, Transient/etiology, Ischemic Attack, Transient/prevention & control, Male, Middle Aged, Platelet Aggregation Inhibitors/therapeutic use, Recurrence, Retinal Vessels/pathology, Retrospective Studies, Stroke/etiology, Stroke/prevention & control, Treatment Outcome
Pubmed
Web of science
Création de la notice
04/08/2009 16:18
Dernière modification de la notice
20/08/2019 17:21
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