Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study

Kuliha, Martin; Roubec, Martin; Goldirova, Andrea; Hurtikova, Eva; Jonszta, Tomáš; Procházka, Václav; Gumulec, Jaromír; Herzig, Roman; Školoudík, David

doi:10.5551/jat.31799

Cited by 7 publications

(6 citation statements)

References 41 publications

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“…108 Six studies investigated DWI lesions in CAS without CPD, 114–119 one of which using a membrane-covered stent. 119 Thirty-eight studies investigated DWI lesions in CAS with CPD: 120–157 one study randomly compared membrane-covered vs. bare-metal stents; 129 one study randomly allocated patients to CAS using flow reversal or distal filter protection; 150 one study randomly assigned to either proximal or distal cerebral protection during CAS; 145 one study compared open vs. closed-cell stent type in a randomised design; 147 three studies compared CAS with CPD vs. CAS without CPD 158–160 and three compared CAS with filter CPD vs. CAS with balloon CPD. 161–163 Three randomised studies, one of which had a 2 × 2 factorial design; 148 investigated clinical and imaging outcomes of CAS according to different regimens of peri-interventional platelet-inhibition 148,164 and statin treatment 144,148 a further study investigated D...…”

Section: Resultsmentioning

confidence: 99%

Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis

Traenka

Engelter

Brown³

et al. 2019

European Stroke Journal

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Aim: To investigate whether lesions on diffusion-weighted imaging (DWIþ) after carotid artery stenting (CAS) or endarterectomy (CEA) might provide a surrogate outcome measure for procedural stroke. Materials and Methods: Systematic MedLine V R database search with selection of all studies published up to the end of 2016 in which DWI scans were obtained before and within seven days after CAS or CEA. The correlation between the underlying log odds of stroke and of DWIþ across all treatment groups (i.e. CAS or CEA groups) from included studies was estimated using a bivariate random effects logistic regression model. Relative risks of DWIþ and stroke in studies comparing CAS vs. CEA were estimated using fixed-effect Mantel-Haenszel models. Results: We included data of 4871 CAS and 2099 CEA procedures (85 studies). Across all treatment groups (CAS and CEA), the log odds for DWIþ was significantly associated with the log odds for clinically manifest stroke (correlation coefficient 0.61 (95% CI 0.27 to 0.87), p ¼ 0.0012). Across all carotid artery stenting groups, the correlation coefficient was 0.19 (p ¼ 0.074). There were too few CEA groups to reliably estimate a correlation coefficient in this subset alone. In 19 studies comparing CAS vs. CEA, the relative risks (95% confidence intervals) of DWIþ and stroke were 3.83 (3.17-4.63, p < 0.00001) and 2.38 (1.44-3.94, p ¼ 0.0007), respectively. Discussion: This systematic meta-analysis demonstrates a correlation between the occurrence of silent brain infarcts on diffusion-weighted imaging and the risk of clinically manifest stroke in carotid revascularisation procedures. Conclusion: Our findings strengthen the evidence base for the use of DWI as a surrogate outcome measure for procedural stroke in carotid revascularisation procedures. Further randomised studies comparing treatment effects on DWI lesions and clinical stroke are needed to fully establish surrogacy.

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Section: Resultsmentioning

confidence: 99%

Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis

Traenka

Engelter

Brown³

et al. 2019

European Stroke Journal

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“…CAS is considered as a less invasive procedure with favourable successful rate for treatment of internal carotid artery stenosis 5. However, even with widespread use of embolic protection devices, new ischaemic cerebral lesions (NICL) after CAS detected by diffusion-weighted imaging MRI (DWI-MRI) are common, ranging from 18% to 57% 6–10. Although most are silent,11 NICL on DWI-MRI after CAS increased the risk of future cerebrovascular events reported by recent study 12.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for new ischaemic cerebral lesions after carotid artery stenting: protocol for a systematic review and meta-analysis

Feng

Bai

et al. 2019

BMJ Open

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IntroductionNew ischaemic cerebral lesions (NICL) detected by diffusion-weighted imaging MRI are common after carotid artery stenting (CAS), with an occurrence rate ranging from 18% to 57%. Many studies reported occurrence of NICL could increase risk of future cerebrovascular events and cognitive impairment. However, controversies about determinants for occurrence of NICL after CAS exist among studies, and one risk factor embodied in an article may not be in another. Aim of this study is to introduce a protocol for a systematic review and meta-analysis to identify risk factors associated with occurrence of NICL after CAS.Methods and analysisAll relevant literature referring to risk factors for occurrence of NICL after CAS will be searched on the major databases, such as PubMed, Embase, Web of Science and the Cochrane Library until 31 December 2018. Literature, which must be randomised controlled trials, case–control studies or cohort studies, will be included in accordance with the prespecified eligibility criteria. The risk of bias will be assessed using the Cochrane Collaboration criteria and the quality of evidence will be assessed with the corresponding scale. Data will be extracted with a form prepared before and analysed using RevMan V.5.3 analyses software. Heterogeneity will be assessed using I2statistic. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Ethics and disseminationThere is no need for ethical approval because primary data will not be attained. The systematic review will be presented at international conferences and published in peer-reviewed journals.PROSPERO registration numberCRD42019121129

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“…The −844 A > G polymorphism (rs2227631) is located in the promotor region of the PAI-1 gene, leads to increased PAI-1 protein levels, and is associated with osteonecrosis of the femoral head, osteoporotic vertebral compression fracture [ 17 ], and acute coronary syndrome [ 18 , 19 ]. The −675 4G > 5G polymorphism (rs1799762), located in the PAI-1 promotor region, is also reported to be associated with various atherosclerotic diseases including venous thromboembolism [ 20 ], ischemic stroke [ 21 ], carotid artery stenosis [ 22 ], renal artery stenosis [ 23 ], and coronary artery disease [ 24 ]. Moreover, these three polymorphisms are reported to be associated with plasma PAI-1 levels [ 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

The Synergistic Effect of Plasminogen Activator Inhibitor-1 (PAI-1) Polymorphisms and Metabolic Syndrome on Coronary Artery Disease in the Korean Population

Park

Sung

Ryu

et al. 2020

JPM

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The most common type of cardiovascular disease is coronary artery disease (CAD), in which a plaque builds up inside the coronary arteries that can lead to a complete blockage of blood flow to the heart, resulting in a heart attack. The CAD may be affected by various factors including age, gender, and lipoprotein disposition as well as genetic factors and metabolic syndrome. In this study, we investigated whether three PAI-1 polymorphisms (−844 G > A, −675 4G > 5G, and +43 G > A) and CAD-related clinical parameters are associated with CAD susceptibility. Genotyping of 463 CAD patients and 401 controls was performed using polymerase chain reaction restriction fragment length polymorphism analysis. We report that the 4G5G genotype (crude odds ratio(COR), 1.392; 95% confidence interval (CI), 1.036–1.871; p = 0.028) and dominant model (4G4G vs. 4G5G + 5G5G; COR, 1.401; 95% CI, 1.060–1.850; p = 0.018; adjust odds ratio, 1.371; 95% CI, 1.027–1.831; p = 0.032) of PAI-1 −675 polymorphisms were associated with increased CAD risk. Haplotype and genotype combinations of PAI-1 −675 and +43 polymorphisms show an increased risk of CAD according to alterations of the −675 polymorphism allele or genotype. Moreover, the PAI-1 -675 polymorphisms show a synergistic effect with the metabolic syndrome component of CAD risk. This study suggests that polymorphisms in the PAI-1 genes along with the metabolic syndrome component of CAD can be useful biomarkers for CAD diagnosis and treatment.

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Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study

Abstract: Aim: New ischemic lesions in the brain can be detected in approximately 50% of patients undergoing carotid artery stenting (CAS).

Cited by 7 publications

References 41 publications

Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis

Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis

Risk factors for new ischaemic cerebral lesions after carotid artery stenting: protocol for a systematic review and meta-analysis

The Synergistic Effect of Plasminogen Activator Inhibitor-1 (PAI-1) Polymorphisms and Metabolic Syndrome on Coronary Artery Disease in the Korean Population

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