Περίληψη:
Introduction: Asymptomatic carotid artery stenosis (ACAS) may cause future stroke and therefore patients with ACAS require best medical treatment. Patients at high risk for stroke may opt for additional revascularization (either surgery or stenting) but the future stroke risk should outweigh the risk for peri/post-operative stroke/death. Current risk stratification for patients with ACAS is largely based on outdated rand-omized-controlled trials that lack the integration of improved medical therapies and risk factor control. Furthermore, recent circulating and imaging biomarkers for stroke have never been included in a risk stratification model. The TAXINOMISIS Project aims to develop a new risk stratification model for cerebrovascular complications in patients with ACAS and this will be tested through a prospective observational multicentre clinical trial performed in six major European vascular surgery centres. Methods and analysis: The risk stratification model will compromise clinical, circulating, plaque and imaging biomarkers. The prospective multicentre observational study will include 300 patients with 50%-99% ACAS. The primary endpoint is the three-year incidence of cerebrovascular complications. Biomarkers will be re-trieved from plasma samples, brain MRI, carotid MRA and duplex ultrasound. The TAXINOMISIS Project will serve as a platform for the development of new computer tools that assess plaque progression based on radiology images and a lab-on-chip with genetic variants that could predict medication response in individual patients. Conclusion: Results from the TAXINOMISIS study could potentially improve future risk stratification in patients with ACAS to assist personalized evidence-based treatment decision-making. © 2020 The Authors.
Συγγραφείς:
Timmerman, N.
Galyfos, G.
Sigala, F.
Thanopoulou, K.
de Borst, G.J.
Davidovic, L.
Eckstein, H.-H.
Filipovic, N.
Grugni, R.
Kallmayer, M.
de Kleijn, D.P.V.
Koncar, I.
Mantzaris, M.D.
Marchal, E.
Matsagkas, M.
Mutavdzic, P.
Palombo, D.
Pasterkamp, G.
Potsika, V.T.
Andreakos, E.
Fotiadis, D.I.
all partners of the TAXINOMISIS Consortium
Λέξεις-κλειδιά:
anticoagulant agent; antilipemic agent; antithrombocytic agent; biological marker, aged; asymptomatic disease; blood; carotid artery obstruction; carotid endarterectomy; cerebrovascular accident; complication; disease exacerbation; endovascular surgery; female; human; lab on a chip; male; middle aged; pharmacogenetic testing; prospective study; risk assessment; stent; theoretical model, Aged; Anticoagulants; Asymptomatic Diseases; Biomarkers; Carotid Stenosis; Clinical Decision Rules; Disease Progression; Endarterectomy, Carotid; Endovascular Procedures; Female; Humans; Hypolipidemic Agents; Lab-On-A-Chip Devices; Male; Middle Aged; Models, Theoretical; Pharmacogenomic Testing; Platelet Aggregation Inhibitors; Prospective Studies; Risk Assessment; Stents; Stroke
