Aspirin Is Not Noninferior to Vitamin K Antagonists for Cervical Artery Dissection

Cervical artery dissection is a common cause of stroke in adults younger than 50 years, yet the optimal antithrombotic regimen to prevent recurrent stroke in these patients is unclear. Anticoagulation had previously been preferred over antiplatelet agents by many clinicians, but more-recent observational studies and a randomized controlled trial (CADISS) showed similarly low event rates with antiplatelet agents and vitamin K antagonists and suggested that a definitive efficacy study might be infeasible owing to the high sample sizes required. Now investigators report results from a second randomized trial that began enrollment 2 years before the CADISS results were published. In TREAT-CAD, 194 patients at 10 stroke centers in Switzerland, G…