Cerebral Small Vessel Disease Predicts Intracranial Hemorrhage With Antithrombotics

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Cerebral small vessel disease also tied to risk for extracranial bleeding

By Lori Solomon HealthDay Reporter

MONDAY, Jan. 8, 2024 (HealthDay News) — Cerebral small vessel disease (SVD) predicts intracranial hemorrhage for patients with cerebrovascular or cardiovascular disease taking antithrombotic therapy, according to a study published online Dec. 25 in the Annals of Neurology.

Kanta Tanaka, M.D., Ph.D., from the National Cerebral and Cardiovascular Center in Suita, Japan, and colleagues determined the excess risk for antithrombotic-related bleeding due to cerebral SVD burden. The analysis included 5,250 patients (median age, 73 years) with cerebrovascular or cardiovascular disease taking oral antithrombotic agents across Japan between 2016 and 2019.

The researchers found that the incidence rate of major bleeding was 0.39 per 100 person-years with SVD score 0; 0.56 with SVD score 1; 0.91 with SVD score 2; 1.35 with SVD score 3; and 2.24 with SVD score 4. For intracranial hemorrhage, the incidence rates were 0.11, 0.33, 0.58, 0.99, and 1.06, respectively, across SVD scores; the corresponding ischemic event incidence rates were 1.82, 2.27, 3.04, 3.91, and 4.07. There was a significantly elevated risk seen for extracranial major bleeding and gastrointestinal bleeding for SVD score 4 versus 0.

“Total SVD score was predictive for intracranial hemorrhage and probably for extracranial bleeding, suggesting the broader clinical relevance of cerebral SVD as a marker for safe implementation of antithrombotic therapy,” the authors write.

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