Impact of Cerebral Small Vessel Disease on Functional Decline: Insights from the Bleeding With Antithrombotic Therapy 2 Study and Related Evidence

Highlights

• Cerebral small vessel disease (SVD) burden independently predicts functional decline in patients receiving oral antithrombotic therapy for cerebrovascular or cardiovascular diseases.
• Higher SVD scores (≥3) are associated with significantly increased odds of worsening disability as measured by the modified Rankin Scale (mRS) over 24 months.
• Functional decline attributed to SVD is predominantly a direct effect, not fully mediated by major bleeding or ischemic events during follow-up.
• Early neurological deterioration in lacunar stroke and pre-existing leukoaraiosis are additional clinical facets of SVD, influencing outcomes and therapeutic considerations.

Background