Objective To explore the clinical characteristics of patients with high-risk non-disabling ischemic cerebrovascular events (HR-NICE) and non-HR-NICE patients as well as the imaging differences in cerebral small vessel disease (CSVD), and to evaluate the predictive value of the total CSVD burden score.

Methods A retrospective analysis was conducted on the clinical data of 314 hospitalized patients with non-disabling ischemic cerebrovascular events in the Department of Neurology at the First Affiliated Hospital of Bengbu Medical University. The patients were divided into HR-NICE group and non-HR-NICE group according to diagnostic criteria. Clinical data, laboratory indicators, and the total CSVD burden score including lacunes, white matter hyperintensities (WMH), cerebral microbleeds (CMB) and perivascular spaces (PVS) were compared between the two groups. Logistic regression analysis was also performed.

Results The HR-NICE group had a significantly higher age and higher prevalence rates of hypertension and diabetes compared to the non-HR-NICE group (P < 0.05). The D-dimer level in the HR-NICE group was significantly higher than that in the non-HR-NICE group (P < 0.01). The detection rates of lacunes and WMH in the HR-NICE group were significantly higher than those in the non-HR-NICE group (P < 0.05). There was a significant difference in the distribution of the total CSVD burden score between the two groups(P < 0.01). Multivariate Logistic regression analysis revealed that the total CSVD burden score was an independent risk factor for HR-NICE (OR=1.748, 95%CI, 1.325 to 2.306, P < 0.01).

Conclusion Patients with HR-NICE are accompanied by traditional risk factors and imaging changes of CSVD. The total CSVD burden score is an independent predictive factor for HR-NICE and can be used to identify high-risk patients.