6/28/23, 12:01 AM CADISS Pathway Feedback Search Clinical Topics Home Studies CADISS CADISS Disease Cervical artery dissection Trial question What is the effect of antiplatelet therapy in patients with extracranial carotid and vertebral artery dissection? Study design Multi-center Open label RCT Population Characteristics of study participants 30.0% female N = 250 70.0% male 250 patients (76 female, 174 male) Inclusion criteria: patients with extracranial carotid and vertebral dissection with onset of symptoms within the past 7 days Key exclusion criteria: intracranial cerebral artery dissection; contraindications to either antiplatelet or anticoagulation drugs, including active peptic ulceration or bleeding peptic ulcer within 1 year; use of antiplatelet or anticoagulants drugs for other reasons (eg, prosthetic heart valves); and pregnancy Interventions N=126 antiplatelet treatment (aspirin, dipyridamole, or clopidogrel alone or in combination, aiming for an INR of 2-3) N=124 anticoagulant treatment (heparin (either UFH or a therapeutic dose of low-molecular- weight heparin) followed by warfarin, aiming for an INR of 2-3) P i t https://web.pathway.md/studies/recyN370P831uOmdz 1/2 6/28/23, 12:01 AM CADISS Pathway Primary outcome Ipsilateral stroke or death at 3 months, in intention-to-treat population 2.0 % 2 1.5 % 1.0 % 1 0.5 % No significant difference 0.0 % Antiplatelet treatment Anticoagulant treatment No significant difference in ipsilateral stroke or death at 3 months, in the intention-to-treat population (2% vs. 1%; OR 0.335, 95% CI 0.01 to 4.23) Secondary outcomes No significant difference in stroke, major bleeding, or death (3% vs. 2%; OR 0.673, 95% CI 0.06 to 5.98) Safety outcomes No significant differences in adverse events, including major bleeding (0% vs. 1%). Conclusion In patients with extracranial carotid and vertebral dissection with onset of symptoms within the past 7 days, antiplatelet treatment was not superior to anticoagulant treatment with respect to ipsilateral stroke or death at 3 months, in the intention-to-treat population. Reference CADISS trial investigators, Markus HS, Hayter E et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol. 2015 Apr;14(4):361-7. Open reference URL https://web.pathway.md/studies/recyN370P831uOmdz 2/2