Detection of patiens with carotid stenosis at high risk of developing vascular complications by the identification of novel miomarkers

Abstract

Background: Currently, stroke is one of the leading causes of death worldwide and the first cause of long-term morbidity in our country. The main risk factor to develop an ischemic stroke is the presence of an atherosclerotic plaque in the wall of the carotid artery. Nowadays the factor that makes subjects with carotid stenosis cross the line from clinical silent to cardiovascular disease is unknown. The available data suggest that there is an interaction between local and systemic factors. So far, several studies have been carried out trying to find a novel biomarker that could detect those subjects that are at high risk of developing a vascular event into the brain to achieve an objective measure for their clinical management. However, no biomarker has been qualified for regular clinical use in carotid artery disease. Objective: The aim of the study is to determine the relationship between the expression of PAI-1, PTX3 and Lp-PLA2 in the carotid plaques of patients with carotid stenosis and the presence or absence of neurological symptoms. Methods: This protocol is a cross-sectional and before and after 1-year follow-up study design in adult subjects with significant carotid stenosis (> 50%) who undergo carotid endarterectomy. The study will include 204 participants, 136 who have developed neurological symptoms and 68 that remain asymptomatic. Recruitment of participants will last 3 years. Participants will be selected as they are admitted in the emergency department or in the outpatients’ department of neurology in the Hospital Doctor Josep Trueta (HDJT) in Girona. Preoperative and postoperative studies and appointments are established in order to do a follow-up of patients and collect all the data. Keywords: management of carotid stenosis; ischemic stroke prevention; biomarkers; hs-CRP; PAI-1; PTX3; Lp-PLA2