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

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).

The associations of SVD presence and (defined as presence of ≥1 SVD marker) and severity (composite SVD score) with ischemic stroke risk were investigated during follow-up using a Cox proportional hazards model adjusted for congestive heart failure, hypertension, age >75, diabetes, stroke, vascular disease, age 65–74, female score. A total of 1419 patients were included in the study. 

"In patients anticoagulated for atrial fibrillation after ischemic stroke or transient ischemic attack, magnetic resonance imaging markers of SVD are associated with an increased risk of ischemic stroke during follow-up; improved stroke prevention treatments are required in this population," wrote the authors. 

The study, "Small Vessel Disease and Ischemic Stroke Risk During Anticoagulation for Atrial Fibrillation After Cerebral Ischemia," is published in the AHA journal Stroke.

DOI: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.029474