Observational study investigates the effect of cerebral small vessel disease on functional decline, indicating significant implications for treatment strategies.
Key Points
This study aims to clarify the impact of cerebral small vessel disease (SVD) on functional decline in patients on antithrombotic therapy.
Prospective, multicenter, observational study conducted at 52 hospitals in Japan from 2016-2019.
4765 patients on oral antithrombotic therapy assessed for functional decline via modified Rankin Scale over 24 months.
Logistic regression and causal mediation analysis were used to evaluate the relationship between SVD burden and functional decline.
ΔmRS score ≥1 increased with SVD score: 13.2% (score 0), 16.1% (1), 20.7% (2), 28.1% (3), and 28.2% (4).
SVD score of 3 associated with adjusted odds ratio of 1.65 (95% CI, 1.27-2.15); SVD score of 4 associated with 1.62 (95% CI, 1.19-2.19).
73.05% of the total effect of SVD score ≥3 on functional decline was attributed to direct effects.