What evidence does the CADISS trial provide regarding the use of anticoagulation and antiplatelet therapy in patients with CeAD?
The CADISS trial supports numerous previous observational studies that found no significant difference in clinical outcomes with the use of anticoagulation compared with antiplatelet therapy in patients with CeAD. In addition, in a follow-up CADISS analysis of dissecting aneurysms (DAs), there was no association between treatment allocation (antiplatelets versus anticoagulants) and whether DAs at baseline persisted at follow-up or whether new DAs developed. During 12 months of follow-up, stroke occurred in 1 of 48 patients with DA and in 7 of 216 patients without DA (age- and sex-adjusted OR, 0.84 [95% CI, 0.10 7.31]; P=0.88). A review of published studies, mainly retrospective, showed a similarly low risk of stroke and no evidence of an increased stroke rate in patients with DA.