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Long-term outcome of cervical artery dissection : IPSYS CeAD: study protocol, rationale, and baseline data of an
Sonia Bonacina1, Mario Grassi2, Marialuisa Zedde3
1Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy.
Insights
Cervical artery dissection (CeAD) is a leading cause of stroke in young adults, but its long-term effects are not well understood. This study tracked CeAD patients to gather crucial data on long-term outcomes and inform personalized treatment strategies.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Cervical artery dissection (CeAD) is a significant cause of ischemic stroke, particularly in younger populations.
- Long-term outcomes and consequences of CeAD remain under-investigated, lacking comprehensive data from large-scale registries.
- Existing research has not fully addressed the long-term clinical trajectory of CeAD patients.
Purpose of the Study:
- To investigate the long-term consequences of cervical artery dissection (CeAD).
- To address clinically important questions regarding CeAD patient outcomes not covered by other registries.
- To provide novel information on the long-term prognosis of CeAD to guide tailored treatment approaches.
Main Methods:
- The Italian Project on Stroke at Young Age - Cervical Artery Dissection (IPSYS CeAD) is a multicenter, observational cohort study.
- Consecutive enrollment of patients with radiologically diagnosed CeAD, collecting baseline demographics, clinical variables, and risk factors.
- Systematic follow-up evaluations conducted at 3-6 months and annually thereafter to assess outcome events like recurrent CeAD, stroke, TIA, thrombotic events, and mortality.
Main Results:
- Data from 1530 CeAD patients (mean age 47.2 years, 43.1% women) were collected between 2000 and 2019 from 39 Italian centers.
- Single vessel dissection occurred in 85.5% of cases, with brain ischemia (TIA or stroke) in 85.1%.
- Longitudinal data are available for 1414 patients (92.4%), with a median follow-up of 36.0 months for those without recurrent events.
Conclusions:
- The IPSYS CeAD project is generating valuable data on the long-term outcomes of cervical artery dissection.
- This comprehensive dataset will enhance understanding of CeAD prognosis and associated risks.
- Findings are expected to facilitate the development of personalized treatment strategies for CeAD patients based on individual characteristics.
Abstract:
Long-term consequences of cervical artery dissection (CeAD), a major cause of ischemic stroke in young people, have been poorly investigated. The Italian Project on Stroke at Young Age - Cervical Artery Dissection (IPSYS CeAD) project is a multicenter, hospital-based, consecutively recruiting, observational, cohort study aimed to address clinically important questions about long-term outcome of CeAD patients, which are not covered by other large-scale registries. Patients with radiologically diagnosed CeAD were consecutively included in the registry. Baseline demographic and clinical variables, as well as information on risk factors, were systematically collected for each eligible patient. Follow-up evaluations were conducted between 3 and 6 months after the initial event (t1) and then annually (t2 at 1 year, t3 at 2 years , and so on), in order to assess outcome events (long-term recurrent CeAD, any fatal/nonfatal ischemic stroke, transient ischemic attack (TIA), or other arterial thrombotic event, and death from any cause). Between 2000 and 2019, data from 1530 patients (age at diagnosis, 47.2 ± 11.5 years; women, 660 [43.1%]) have been collected at 39 Italian neurological centers. Dissection involved a single vessel in 1308 (85.5%) cases and caused brain ischemia in 1303 (85.1%) (190 TIA/1113 ischemic stroke). Longitudinal data are available for 1414 (92.4%) patients (median follow-up time in patients who did not experience recurrent events, 36.0 months [25th to 75th percentile, 63.0]). The collaborative IPSYS CeAD effort will provide novel information on the long-term outcome of CeAD patients. This could allow for tailored treatment approaches based on patients' individual characteristics.
