Abstract 32: Ischemic and hemorrhagic risks of patients with Basal Ganglia Perivascular Spaces on Antithrombotic Therapy

• DOI: 10.1161/str.56.suppl_1.32
• Publication Date: 2025-01-30T10:27:49Z
• Authors: Soya Iwamoto; Kaori Miwa; Masatoshi Koga; Kanta Tanaka; Sohei Yoshimura; Yusuke Yakushiji; Makoto Sasaki; Haruhiko Hoshino; Masayuki Shiozawa; Yoshiki Yagita; Kohsuke Kudo; Yoshinari Nagakane; Masafumi Ihara; Teruyuki Hirano; Kazunori Toyoda
• Keywords: Perivascular space; Stroke; Basal (medicine)

Background: Enlarged perivascular spaces (PVS), a marker of cerebral small vessel disease (SVD), are considered to increase the risk stroke. However, there is limited data on benfits and harms antithrombotic agents in patients with PVS. We assessed association PVS hemorrhagic or ischemic events receiving agents. Methods: This an investigator-initiated, prospective, multicenter observational study that enrolled cerebrovascular cardiovascular diseases who were taking oral from 52 hospitals across Japan between 2016 2019. All participants underwent baseline multimodal MRI. The MRI scans centrally evaluated for radiologic indicators related SVD, including white matter hyperintensities (WMH), microbleeds (CMBs), lacunes, basal ganglia enlarged-perivascular (BGPVS), cortical superficial siderosis, using visual scale. outcomes included major bleeding, intracranial hemorrhage, events, stroke, mortality. Results: Of analyzed 5,250 (1,736 women; median age 73 [IQR 66–79] years), antiplatelets anticoagulants administered at 3,948 (75.2%) 1,565 (29.8%), respectively. During 2 (IQR1.8–2.0) years, 278 197 strokes, 93 55 217 deaths observed. distribution BGPVS was as follows: 0 475 (9.4%), 1-10 2615 (51.6%), 11+ 1975 (39.9%). A higher burden associated older age, lower proportion women, rates hypertension smoking, eGFR values, prevalence CMBs, WMH. bleeding (1–10 BGPVS: adjusted hazard ratio (aHR) 1.49, [95% confidence interval CI 0.76–7.92], aHR 3.27 [1.09–11.57] versus BGPVS; p trend = 0.035) stroke 1.79 [0.90–3.57], 2.39 [1.19–4.81]; 0.014). In contrast, not significantly increased Conclusions: medication might be useful clinical decision making.