Small vessel disease tied to increased risk of recurrent stroke: Study

UK: Small vessel disease (SVD) in patients anticoagulated for atrial fibrillation after stroke, is associated with an increased risk of recurrent ischemic stroke, suggests a recent study in the journal Stroke.

Even after anticoagulation for atrial fibrillation, recurrent ischemic stroke may occur the cause of which is uncertain but might include small vessel occlusion. David J. Werring, UCL Institute of Neurology, London, United Kingdom, and colleagues investigated whether MRI markers of cerebral SVD are associated with the risk of ischemic stroke during follow up in patients anticoagulated for atrial fibrillation after transient ischemic attack or recent ischemic stroke. 

For the purpose, the researchers analyzed data from a prospective multicenter inception cohort study of ischemic stroke or transient ischemic attack anticoagulated for atrial fibrillation (CROMIS-2 [Clinical Relevance of Microbleeds in Stroke Study]. Markers of SVD were rated on baseline brain magnetic resonance imaging: basal ganglia perivascular spaces (number ≥11); cerebral microbleeds (number ≥1); lacunes (number ≥1); and white matter hyperintensities (periventricular Fazekas grade 3 or deep white matter Fazekas grade ≥2).