Brain Infarction, Cervical Artery Dissection, Stroke
Conditions
Keywords
Polymorphism, genetic, Risk factors, Carotid Artery, Internal, Dissection, Vertebral Artery Dissection, Genetic predisposition, Outcome, Therapy
Brief summary
The main purpose of this study is to look for genetic and environmental risk factors of cervical artery dissections, a major cause of ischemic stroke in young adults, in a large multicenter case-control trial
Detailed description
Background: Cervical artery dissections (CAD) are a major cause of ischemic stroke, longstanding disability, and occasionally death in young adults. Several lines of evidence suggest genetic predisposition for CAD. Previous genetic studies were, however, inconclusive mainly due to insufficient numbers of patients. Our hypothesis is that CAD is a multifactorial disease caused by yet largely unidentified genetic variants and environmental factors, which may interact. Aim: Our main aim is to look for genetic and environmental risk factors and gene-environment interactions potentially underlying CAD. In addition, therapeutic aspects are addressed in the setting of a multicenter registry. Methods: We organized a multinational European network, CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) which targets at increasing our knowledge on the pathophysiological mechanisms of this disease in a large, representative patient population. Within this network, we are aiming to perform a de novo genetic association analysis using both a genome-wide and a candidate gene approach. For this purpose, 1130 patients with CAD, 1130 patients with non-CAD ischemic stroke, and 1890 healthy controls are being recruited, and detailed clinical, laboratory, diagnostic, therapeutic and outcome data are being collected from all participating patients. We are expecting to reach the above numbers of subjects by the end of 2008. Analyses of the CADISP database might clarify a number of debated issues, including risk factors, stroke preventive treatment, and outcome predictors of CAD. We present the strategy of a collaborative project searching for genetic risk factors of cervical artery dissections. We hope that the CADISP network will provide detailed and novel data on risk factors and treatment aspects of CAD.
Interventions
None listed
Sponsors
Cervical Artery Dissections and Ischemic Stroke Patients - Consortium
Study design
Observational model
CASE_CONTROL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
GROUP1: Inclusion Criteria: * Typical radiological aspect of dissection\* in a cervical artery (carotid and/or vertebral);\* Mural hematoma, pseudoaneurysm, long tapering stenosis, intimal flap, double lumen, or occlusion \> 2 cm above the carotid bifurcation revealing a pseudo aneurysm or a long tapering stenosis after recanalisation * Written informed consent
Exclusion criteria
* Purely intracranial dissection * Dissection occurring after an endovascular procedure * Known mendelian genetic disorder that can explain the dissection (e.g. vascular Ehlers-Danlos syndrome) GROUP2: Inclusion Criteria: * Recent ischemic stroke * No signs of CAD on extracranial duplex sonography and angiography (digital subtraction or magnetic resonance or CT), performed \< 7 days after the stroke * Written informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| association of genetic polymorphisms with cervical artery dissections | 2009 |
Secondary
| Measure | Time frame |
|---|---|
| association of environmental risk factors with cervical artery dissections | 2009 |
| gene-environment interactions | 2009 |
Countries
Argentina, Belgium, Finland, France, Germany, Italy, Switzerland, Turkey (Türkiye), United Kingdom
Outcome results
None listed