Young people have a stroke if they exercise well?

The results of the study support the use of vitamin K antagonists for oral anticoagulation therapy in young and middle-aged carotid artery tear stroke patients.

There are news reports that a yoga expert on the Internet shoots instructional videos showing super-difficult "inverted push-ups.
"
A few hours after filming, she began to blur her vision, weakness, and headaches.

Two days later, not only did the symptoms not relieved, but he also found that his pupils had become different in size, so he went to the hospital.

The results of the inspection came out, such as five thunderstorms-a stroke.

Carotid artery tear is the main cause of stroke in young and middle-aged people under 50 years of age.

According to research reports, cerebral ischemic events caused by carotid artery tears account for only 2% of ischemic strokes (commonly known as strokes) in all people, but the proportion of ischemic strokes in young and middle-aged people is as high as 10%-25%.
An important cause of ischemic stroke in young and middle-aged people.

Historically, clinicians are more inclined to use vitamin K antagonists for oral anticoagulation in patients with carotid artery tears.

However, some current guidelines based on existing evidence suggest the use of aspirin for treatment through observational studies.

If it proves to be non-inferior to vitamin K antagonists, aspirin may be preferred because of its ease of use and lower cost.

So, compared with vitamin K antagonists, can aspirin be effective in patients with carotid artery tears? To this end, neurologists from the University of Basel in Switzerland carried out a corresponding non-inferiority study, and the results were published in the latest "Lancet" sub-Journal Lancet Neurology.

Researchers conducted a multicenter, randomized, open-label, non-inferiority trial in 10 stroke centers in Switzerland, Germany, and Denmark.

Patients aged> 18 years old, symptomatic within 2 weeks before enrollment, and carotid artery tear confirmed by MRI were randomly assigned (1:1) to receive aspirin 300 mg once a day or vitamin K antagonist (target international normalized ratio [INR] maintained at 2.
0-3.
0) treatment for 90 days.

The primary endpoint is to evaluate the clinical outcome (stroke, major hemorrhage, or death) and MRI results (new ischemic or hemorrhagic Brain disease).

Between September 11, 2013 and December 21, 2018, a total of 194 patients were enrolled; 100 (52%) were assigned to the aspirin group, and 94 (48%) were assigned to the vitamin K antagonist group.

21 patients (23%) in the aspirin group and 12 patients (15%) in the vitamin K antagonist group reached the main treatment focus (absolute difference 8%, non-inferiority p=0.
55).

Thus, the results of the study did not show the non-inferiority of aspirin.

At the same time, 7 patients (8%) in the aspirin group and none in the vitamin K antagonist group had an ischemic stroke.

One patient in each group had major intracranial hemorrhage, but there was no death.

14 patients (15%) in the aspirin group and 11 patients (13%) in the vitamin K antagonist group had subclinical MRI results.

There were 19 adverse events in the aspirin group and 26 in the vitamin K antagonist group.

In summary, the research results support the use of vitamin K antagonists for oral anticoagulation in young and middle-aged carotid artery tear stroke patients.

 Reference: Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial.
https://doi.
org/10.
1016/S1474-4422(21)00044-2.