Looking For Genetic and Environmental Risk Factors and Therapeutic Aspects in Cervical Artery Dissections
- Conditions
- Cervical Artery DissectionStrokeBrain Infarction
- Registration Number
- NCT00657969
- Lead Sponsor
- Cervical Artery Dissections and Ischemic Stroke Patients - Consortium
- 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.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 4169
- 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
- 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
Exclusion Criteria:
- Possible cerebral ischemia but normal cerebral imaging
- CAD cannot be ruled out (e.g.persistent arterial occlusion without mural hematoma)
- Endovascular or surgical procedure on the coronary, cervical or cerebral arteries during the 48 hours preceding the cerebral infarction
- Cardiopathies with a very high embolic risk (Mechanical prosthetic valves, mitral stenosis with atrial fibrillation, intracardiac tumor, infectious endocarditis, myocardial infarction<4 months)
- Arterial vasospasm following a subarachnoid haemorrhage
- Auto-immune disease possibly responsible for the cerebral infarction
- Known monogenic disease responsible for the cerebral infarction
GROUP3:
Inclusion criteria:
- Individuals from the general population without history of stroke, dissections in any artery, transient ischemic attack, coronary artery disease, peripheral artery disease
- Written informed consent
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method association of genetic polymorphisms with cervical artery dissections 2009
- Secondary Outcome Measures
Name Time Method association of environmental risk factors with cervical artery dissections 2009 gene-environment interactions 2009
Trial Locations
- Locations (24)
Sanatorio Allende
🇦🇷Cordoba, Argentina
Department of Neurology, University Hospital of Brussels (ULB)
🇧🇪Brussels, Belgium
Department of Neurology, University Hospital of Leuven
🇧🇪Leuven, Belgium
Department of Neurology, Helsinki University Central Hospital
🇫🇮Helsinki, Finland
Department of Neurology, University Hospital of Amiens
🇫🇷Amiens, France
Department of Neurology, University Hospital of Besançon
🇫🇷Besançon, France
Department of Neurology, University Hospital of Dijon
🇫🇷Dijon, France
Department of Neurology, University Hospital of Lille
🇫🇷Lille, France
Inserm U744 Institut Pasteur de Lille
🇫🇷Lille, France
Rehabilitation Center, Schmieder-Klinik
🇩🇪Heidelberg, Germany
Department of Neurology, University Hospital of Heidelberg
🇩🇪Heidelberg, Germany
Department of Neurology, Hospital of Ludwigshafen
🇩🇪Ludwigshafen, Germany
Department of Neurology, University Hospital of Munich
🇩🇪Munich, Germany
Department of Neurology, University Hospital Pitié-Salpêtrière
🇫🇷Paris, France
Department of Neurology, University Hospital Sainte-Anne
🇫🇷Paris, France
Department of Neurology, University Hospital of Brescia
🇮🇹Brescia, Italy
Department of Neurology, Ospedale Maggiore Policlinico di Milano
🇮🇹Milano, Italy
Ospedale Milano San Raffaele
🇮🇹Milano, Italy
Department of Neurology, University Hospital Milano-Bicocca
🇮🇹Monza, Italy
Department of Neurology, University Hospital of Perugia
🇮🇹Perugia, Italy
Rehabilitation Center, IRCCS Santa Lucia, Roma
🇮🇹Rome, Italy
Department of Neurology, University Hospital of Basel
🇨ðŸ‡Basel, Switzerland
Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University
🇹🇷Istanbul, Turkey
Department of Neuroscience, St George's University Hospital of London
🇬🇧London, United Kingdom