Abstract WP157: Cerebral small vessel diseases in young adults with ischemic stroke receiving long-term antithrombotic therapy
Rattachement africain : jp. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Introduction: Cerebral small vessel disease (SVD) is frequently observed in older adults and represents a major cause of future stroke, but its prevalence and prognostic implications in young adults remain elusive. We aimed to determine whether SVD burden and features could identify young adults at higher risk of ischemic stroke recurrence and bleeding events during antithrombotic therapy. Methods: This was a prospective, multicenter observational study enrolling patients with cerebrovascular or cardiovascular diseases who were taking oral antithrombotic agents. This substudy focused on patients aged ≦55 years with a history of ischemic stroke. Baseline brain MRI was performed to assess SVD (white matter hyperintensities including periventricular hyperintensities [PVH] and deep subcortical white matter hyperintensities [DSWMH], cerebral microbleeds [CMBs], lacune, enlarged perivascular space, cortical superficial siderosis), and non-lacunar infarct. All images were centrally reviewed and the SVD score was assessed (range: 0–4). The outcomes were recurrent ischemic stroke, major bleeding, intracranial hemorrhage (ICH), and all-cause mortality. We assessed prospective associations of SVD with outcomes via Cox regression model adjusted for demographic and vascular risk factors. Results: Among the 5,378 patients enrolled, 428 were young adults aged ≦55 years (mean age: 46 ± 6 years; 35% women). Median SVD score was 1 (IQR: 0–1). During a median follow-up of 2 [1.80–2.03] years, 18 ischemic strokes, 4 major bleeding, and 3 ICH, corresponding to incidence rates of 2.22, 0.48, and 0.36 per 100 person-years, respectively. Of the 3 ICH, two were subdural hematomas and one was a subarachnoid hemorrhage. No all-cause deaths were observed. SVD score ≧2, strictly lobar CMBs ≥5, moderate PVH (Fazekas score ≧2) and severe DSWMH (Fazekas score ≧3) were each associated with ischemic strokes (adjusted hazard ratio: 2.96 [95%CI; 1.09–8.03], 12.5 [1.49–104.1], 3.19 [1.05–9.69], and 4.51 [1.19–17.1], respectively). Due to the low number of bleeding events, multivariable analysis was not feasible. The presence of deep CMBs increased the risk of major bleeding and ICH in univariable analysis (unadjusted hazard ratio:12.7 [1.78–90.21] and 12.5 [1.13–138.0], respectively). Conclusions: Although SVD was infrequently observed in young adults with ischemic stroke receiving antithrombotic therapy, it was associated with a higher absolute risk of recurrent ischemic stroke than of bleeding events.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Abstract WP157: Cerebral small vessel diseases in young adults with ischemic stroke receiving long-term antithrombotic therapy
- Date Crossref
- 01/02/2026
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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National Cerebral and Cardiovascular Center pays non établi dans la noticeÉtablissement de santé
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Kindai University Hospital pays non établi dans la noticeÉtablissement de santé
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Kansai Medical University pays non établi dans la noticeUniversité ou école supérieure
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Iwate Medical University pays non établi dans la noticeUniversité ou école supérieure
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Hokkaido University pays non établi dans la noticeUniversité ou école supérieure
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Jichi Medical University pays non établi dans la noticeUniversité ou école supérieure
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Japanese Red Cross Kumamoto Hospital pays non établi dans la noticeÉtablissement de santé
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Kohnan Hospital pays non établi dans la noticeÉtablissement de santé
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Kyoto first Red Cross hospital pays non établi dans la noticeÉtablissement de santé
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University of Tsukuba pays non établi dans la noticeUniversité ou école supérieure
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Kitasato University pays non établi dans la noticeUniversité ou école supérieure
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Kawasaki Medical School pays non établi dans la noticeUniversité ou école supérieure
National Cerebral and Cardiovascular Center, Kindai University Hospital et Kansai Medical University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.