International Stroke Conference 2025  /  Large Vessel Disease from Arteries to Veins (Non-Acute Treatment) Posters  /  Prevelance of Triggers and Risk Factors in Cervical Artery Dissection
Logo

American Heart Association

  106
  0

Final ID: TP221

Prevelance of Triggers and Risk Factors in Cervical Artery Dissection

Abstract Body: Introduction
Cervical artery dissection (CAD) accounts for nearly 2% of all ischemic strokes but up to 25% of ischemic strokes in young adults. Dissection is likely precipitated by the interplay between risk factors (migraine, low body mass index), environmental triggers (cervical trauma or infection), and genetic connective tissue abnormalities (e.g. Ehlers-Danlos or Marfan’s disease). In this study, we delineate the prevalence of triggers and risk factors in a multicenter cohort of cervical artery dissection.
Methods
This is a post-hoc analysis of the Antithrombotic for Stroke Prevention in Cervical Artery Dissection Study (STOP-CAD). We recorded information using the admission data on risk factors (migraine), triggers (upper respiratory infection, COVID-19, and minor cervical injury), and whether the patient had a known connective tissue disorder (CTD). We determined the prevalence of risk factors, triggers, and presence of CTD in patients with cervical artery dissection as well as the interplay between these factors in the pathogenesis of CAD.
Results
We identified 4023 patients with CAD, the mean age was 47 years and 45% were women. A history of migraines was present in 16.6% (668) patients. At least one environmental trigger was present in 26.3% of patients (1061 patients), with minor cervical injury being the most common (22.2%, 892 patients), then upper respiratory infections (6.2%, 251 patients), and COVID-19 (1.2%, 49 patients). Among cervical injury, the most common was chiropractic manipulation (5.7%, 228 patients). Only 2% (83 patients) were known to have a CTD with Fibromuscular Dysplasia being the most common (0.6%, 23 patients). Among the entire STOP-CAD cohort, only 5 patients (0.1%) had evidence of at least one trigger, risk factor, or a known connection tissue disease. On the other hand, 61% of patients (2441 patients) had none of the three recorded.
Conclusion
In patients with CAD, the absence of any risk factor, trigger, or known CTD is common and should not lead to dismissing a dissection diagnosis in patients with symptoms concerning for CAD.
  • Yaghi, Shadi  ( Brown University , Providence , Rhode Island , United States )
  • Marialuisa, Zedde  ( AUSL , Emilio Reggio , Italy )
  • Khazaal, Ossama  ( Temple University Hospital , Philadelphia , Pennsylvania , United States )
  • Martins, Sheila  ( Hospital de Clinicas Porto Alegre , Porto Alegre , Brazil )
  • Choi, Richard  ( Christiana , Toronto , Ontario , Canada )
  • Mohammadzeh, Nahid  ( Brown University , Providence , Rhode Island , United States )
  • Marto, Joao Pedro  ( Hospital de Egas Moniz , LISBOA , Portugal )
  • Tentolouris Piperas, Vasileios  ( Aiginitio Hospital , Athens , Greece )
  • Fridman, Sebastian  ( Western University , London , Ontario , Canada )
  • Mallick, Dania  ( Corewell Health Hospitals , Grand Rapids , Michigan , United States )
  • Siegler, James  ( University of Chicago , Chicago , Illinois , United States )
  • Shu, Liqi  ( Brown University , Providence , Rhode Island , United States )
  • Liebeskind, David  ( UCLA , Los Angeles , California , United States )
  • Stretz, Christoph  ( Brown University , East Greenwich , Rhode Island , United States )
  • Pan, Kelly  ( Brown University , Providence , Rhode Island , United States )
  • Yaddanapudi, Sridhara  ( Thomas Jefferson university hospita , Philadelphia , Pennsylvania , United States )
  • De Marco, Giovanna  ( AUSL , Emilio Reggio , Italy )
  • Aguiar De Sousa, Diana  ( Lisbon Central University Hospital , Lisboa , Portugal )
  • Bakradze, Ekaterina  ( University of Alabama at Birmingham , Birmiham , Alabama , United States )
  • Dantu, Vishnu  ( Barrow Neurological Institute , Phoenix , Arizona , United States )
  • Traenka, Christopher  ( University Hospital Basel , Oberwil , Switzerland )
  • Cheng, Yee Kuang  ( Yale University , New Haven , Connecticut , United States )
  • Mandel, Daniel  ( west virginia university , Bridgeport , West Virginia , United States )
  • Carrasco Wall, Victor  ( Natividad Medical Center , Mexico , Mexico )
  • De Havenon, Adam  ( Yale University , New Haven , Connecticut , United States )
  • Eltatawy, Ali  ( University of Cinncinati , Cinncinati , Ohio , United States )
  • Saleh Velez, Faddi  ( University of oklahoma , Oklahoma , Oklahoma , United States )
  • Aruaz, Antonio  ( Mexico National Institute of Health , Mexico , Mexico )
  • Indraswari, Fransisca  ( Brown Neurology , Providence , Rhode Island , United States )
  • Patel, Shivam  ( Hartford Hospital , Hartford , Connecticut , United States )
  • Sarwat, Zoha  ( Hartford Hospital , Hartford , Connecticut , United States )
  • Vishnu, Venugopalan  ( AIIMS New Delhi , New Delhi , India )
  • Lodhi, Omair Ul Haq  ( University of Minnesota , Minnesota , Minnesota , United States )
  • Ghani, Mohammad  ( University of Louisville , Louisville , Kentucky , United States )
  • Liu, Shilin  ( University of Science and Technology , Shanghai , China )
  • Romoli, Michele  ( AUSL , Bologna , Italy )
  • Rosa, Sara  ( Lisbon Central University Hospital , Lisboa , Portugal )
  • Qureshi, Abid  ( UNIVERSITY OF KANSAS MEDICAL CENTER , Kansas City , Kansas , United States )
  • Nehme, Ahmad  ( University of Caen , Caen , France )
  • Guo, Xiaofan  ( Loma Linda University , Loma Linda , California , United States )
  • Kaufmann, Josefin Emelie  ( University Hospital Basel , Basel , Switzerland )
  • Longoni, Marco  ( AUSL , Bologna , Italy )
  • Barata, Vasco  ( Medicine Coimbra , Porto , Portugal )
  • Henninger, Nils  ( UMass Chan Medical School , Shrewsbury , Massachusetts , United States )
  • Al Kasab, Sami  ( Medical University of South Carolin , Charleston , South Carolina , United States )
  • Furie, Karen  ( Department of Neurology , Providence , Rhode Island , United States )
  • Sarvath, Mohammed  ( West Virginia University , Morgantown , West Virginia , United States )
  • Zubair, Adeel  ( Yale University , New Haven , Connecticut , United States )
  • Khan, Farhan  ( Brown University , Providence , Rhode Island , United States )
  • Heldner, Mirjam  ( Bern University , Bern , Switzerland )
    • Author Disclosures:
    Shadi Yaghi: DO NOT have relevant financial relationships | Zedde Marialuisa: No Answer | Ossama Khazaal: No Answer | Sheila Martins: DO have relevant financial relationships ; Speaker:Boehringer Ingelheim:Active (exists now) ; Research Funding (PI or named investigator):Ministry of Health of Brazil:Active (exists now) ; Speaker:Daiichi Sankyo:Past (completed) ; Speaker:Pfizer:Past (completed) ; Speaker:Bayer:Past (completed) ; Speaker:Servier:Past (completed) ; Speaker:Novo Nordisk:Past (completed) ; Speaker:Novartis:Past (completed) ; Speaker:Penumbra:Past (completed) ; Speaker:Astra Zeneca:Active (exists now) ; Speaker:Medtronic:Active (exists now) | Richard Choi: No Answer | Nahid Mohammadzeh: No Answer | Joao Pedro Marto: DO NOT have relevant financial relationships | Vasileios Tentolouris Piperas: DO NOT have relevant financial relationships | SEBASTIAN FRIDMAN: No Answer | Dania Mallick: DO NOT have relevant financial relationships | James Siegler: DO have relevant financial relationships ; Research Funding (PI or named investigator):Viz.ai:Active (exists now) ; Research Funding (PI or named investigator):NIH:Active (exists now) ; Research Funding (PI or named investigator):Philips:Active (exists now) ; Research Funding (PI or named investigator):Medtronic:Active (exists now) | Liqi Shu: DO NOT have relevant financial relationships | David Liebeskind: DO NOT have relevant financial relationships | Christoph Stretz: DO have relevant financial relationships ; Other (please indicate in the box next to the company name):Massachusetts General Hospital/Boston Scientific:Past (completed) | Kelly Pan: DO NOT have relevant financial relationships | Sridhara Yaddanapudi: DO NOT have relevant financial relationships | Giovanna De Marco: DO NOT have relevant financial relationships | Diana Aguiar De Sousa: DO have relevant financial relationships ; Speaker:AstraZeneca:Past (completed) ; Research Funding (PI or named investigator):MSD:Active (exists now) ; Research Funding (PI or named investigator):Fundação para a Ciência e Tecnologia:Active (exists now) ; Advisor:Jonhson & Johnson:Past (completed) ; Advisor:Organon:Past (completed) ; Advisor:Daiichi-Sankyo:Past (completed) | Ekaterina Bakradze: DO NOT have relevant financial relationships | Vishnu Dantu: DO NOT have relevant financial relationships | Christopher Traenka: DO NOT have relevant financial relationships | Yee Kuang Cheng: DO NOT have relevant financial relationships | Daniel Mandel: DO NOT have relevant financial relationships | Victor Carrasco Wall: DO NOT have relevant financial relationships | Adam de Havenon: DO have relevant financial relationships ; Research Funding (PI or named investigator):NIH/NINDS:Active (exists now) ; Researcher:UptoDate:Active (exists now) ; Individual Stocks/Stock Options:Certus:Active (exists now) ; Individual Stocks/Stock Options:TitinKM:Active (exists now) ; Consultant:Novo Nordisk:Active (exists now) ; Research Funding (PI or named investigator):AAN:Active (exists now) | ALI ELTATAWY: No Answer | Faddi Saleh Velez: DO NOT have relevant financial relationships | Antonio Aruaz: No Answer | Fransisca Indraswari: DO NOT have relevant financial relationships | Shivam Patel: No Answer | Zoha Sarwat: DO NOT have relevant financial relationships | Venugopalan Vishnu: No Answer | Omair ul haq Lodhi: DO NOT have relevant financial relationships | Mohammad Ghani: DO NOT have relevant financial relationships | Shilin Liu: No Answer | Michele Romoli: DO NOT have relevant financial relationships | Sara Rosa: DO have relevant financial relationships ; Research Funding (PI or named investigator):European Society of Radiology:Active (exists now) ; Research Funding (PI or named investigator):MSD:Active (exists now) | Abid Qureshi: DO NOT have relevant financial relationships | Ahmad Nehme: DO NOT have relevant financial relationships | Xiaofan Guo: No Answer | Josefin Emelie Kaufmann: DO have relevant financial relationships ; Researcher:Goldschmidt Jacobson Foundation:Past (completed) | marco longoni: DO NOT have relevant financial relationships | Vasco Barata: DO NOT have relevant financial relationships | Nils Henninger: DO NOT have relevant financial relationships | Sami Al Kasab: DO NOT have relevant financial relationships | Karen Furie: DO have relevant financial relationships ; Consultant:Janssen/BMS:Active (exists now) | Mohammed Sarvath: No Answer | Adeel Zubair: DO NOT have relevant financial relationships | Farhan Khan: No Answer | Mirjam Heldner: DO NOT have relevant financial relationships
Meeting Info:

International Stroke Conference 2025

2025

Los Angeles, CA

Session Info:

Large Vessel Disease from Arteries to Veins (Non-Acute Treatment) Posters

Thursday, 02/06/2025 , 07:00PM - 07:30PM

Poster Abstract Session

More abstracts on this topic:
A Case Series of Papillary Fibroelastomas on the Coumadin ridge

Aboukhatwa Omar, Akiki Elias, Kurmann Reto, Larson Kathryn, Keeney Michael, Bois Melanie, Klarich Kyle

Ascending Thoracic Aortic Aneurysms in a Veterans Affairs Health System: Longitudinal Outcomes and Risk Factors

Gomez Axel, Carroway William, Ge Liang, Boskovski Marko, Tseng Elaine

More abstracts from these authors:
Antithrombotic trends before and after publication of randomized clinical trials in cervical artery dissection: A secondary analysis of the STOP-CAD Study

Penckofer Mary, Salehi Omran Setareh, Seiffge David, Arnold Marcel, Marialuisa Zedde, Zubair Adeel, Marto Joao Pedro, Ghannam Malik, Engelter Stefan, Traenka Christopher, Mac Grory Brian, Shu Liqi, Kam Wayneho, Elnazeir Marwa, Romoli Michele, Saleh Velez Faddi, Siegler James, Strelecky Lukas, Yaghi Shadi, Henninger Nils, Muppa Jayachandra, Bakradze Ekaterina, Heldner Mirjam, Katheryna Antonenko

Intravenous Thrombolysis in Cervical Artery Dissection-Related Stroke: A Nationwide Study

Shu Liqi, Siegler James, Strelecky Lukas, Mandel Daniel, Stretz Christoph, Khan Farhan, Furie Karen, Yaghi Shadi, Lee Elizabeth, Field Thalia, Guo Xiaofan, Henninger Nils, Keser Zafer, Khan Muhib, Mistry Eva, Nguyen Thanh

You have to be authorized to contact abstract author. Please, Login
Not Available

Readers' Comments

We encourage you to enter the discussion by posting your comments and questions below.

Presenters will be notified of your post so that they can respond as appropriate.

This discussion platform is provided to foster engagement, and simulate conversation and knowledge sharing.

 

You have to be authorized to post a comment. Please, Login or Signup.

   Rate this abstract  (Maximum characters: 500)