Looking For Genetic and Environmental Risk Factors and Therapeutic Aspects in Cervical Artery Dissections

NCT ID: NCT00657969

Last Updated: 2009-10-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

4169 participants

Study Classification

OBSERVATIONAL

Study Start Date

2005-07-31

Study Completion Date

2009-09-30

Brief Summary

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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

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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.

Conditions

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Cervical Artery Dissection Stroke Brain Infarction

Study Design

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Observational Model Type

CASE_CONTROL

Study Groups

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1

CAD-group (Cervical Artery Dissection - group): consecutive patients with cervical artery dissection, with or without associated cerebral ischemia, hospitalized in one of the participating neurological centers; standardized inclusion and exclusion criteria apply

No interventions assigned to this group

2

IS-group (Ischemic Stroke - Group): patients selected among consecutive patients hospitalized for an ischemic stroke without CAD, in the same centers as patients from group1, frequency-matched on age and gender with group1; standardized inclusion and exclusion criteria apply

No interventions assigned to this group

3

HC-group (Healthy Control - Group): DNA of healthy individuals from existing DNA-databases will be used as controls for the Belgian, French, German and Swiss centers; the other centers are recruiting their own age- and sex-matched healthy controls; individuals from the 3 groups (CAD, IS and HC) are strictly matched on geographical origin in order to avoid stratification bias

No interventions assigned to this group

Eligibility Criteria

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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


* 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


* 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

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:


* 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:
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cervical Artery Dissections and Ischemic Stroke Patients - Consortium

NETWORK

Sponsor Role lead

Responsible Party

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University Hospitals of Heidelberg and Lille

Principal Investigators

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Stéphanie Debette, MD, PhD

Role: STUDY_DIRECTOR

Department of Neurology (EA2691), University Hospital of Lille; Inserm, U744, Pasteur Institute, Lille, France

Caspar Grond-Ginsbach, PhD

Role: STUDY_CHAIR

Department of Neurology, University Hospital of Heidelberg, Germany

Didier Leys, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Neurology (EA2691), University Hospital of Lille, France

Locations

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Sanatorio Allende

Córdoba, , Argentina

Site Status

Department of Neurology, University Hospital of Brussels (ULB)

Brussels, , Belgium

Site Status

Department of Neurology, University Hospital of Leuven

Leuven, , Belgium

Site Status

Department of Neurology, Helsinki University Central Hospital

Helsinki, , Finland

Site Status

Department of Neurology, University Hospital of Amiens

Amiens, , France

Site Status

Department of Neurology, University Hospital of Besançon

Besançon, , France

Site Status

Department of Neurology, University Hospital of Dijon

Dijon, , France

Site Status

Department of Neurology, University Hospital of Lille

Lille, , France

Site Status

Inserm U744 Institut Pasteur de Lille

Lille, , France

Site Status

Department of Neurology, University Hospital Pitié-Salpêtrière

Paris, , France

Site Status

Department of Neurology, University Hospital Sainte-Anne

Paris, , France

Site Status

Rehabilitation Center, Schmieder-Klinik

Heidelberg, , Germany

Site Status

Department of Neurology, University Hospital of Heidelberg

Heidelberg, , Germany

Site Status

Department of Neurology, Hospital of Ludwigshafen

Ludwigshafen, , Germany

Site Status

Department of Neurology, University Hospital of Munich

Munich, , Germany

Site Status

Department of Neurology, University Hospital of Brescia

Brescia, , Italy

Site Status

Department of Neurology, Ospedale Maggiore Policlinico di Milano

Milan, , Italy

Site Status

Ospedale Milano San Raffaele

Milan, , Italy

Site Status

Department of Neurology, University Hospital Milano-Bicocca

Monza, , Italy

Site Status

Department of Neurology, University Hospital of Perugia

Perugia, , Italy

Site Status

Rehabilitation Center, IRCCS Santa Lucia, Roma

Rome, , Italy

Site Status

Department of Neurology, University Hospital of Basel

Basel, , Switzerland

Site Status

Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University

Istanbul, , Turkey (Türkiye)

Site Status

Department of Neuroscience, St George's University Hospital of London

London, , United Kingdom

Site Status

Countries

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Argentina Belgium Finland France Germany Italy Switzerland Turkey (Türkiye) United Kingdom

References

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Engelter ST, Brandt T, Debette S, Caso V, Lichy C, Pezzini A, Abboud S, Bersano A, Dittrich R, Grond-Ginsbach C, Hausser I, Kloss M, Grau AJ, Tatlisumak T, Leys D, Lyrer PA; Cervical Artery Dissection in Ischemic Stroke Patients (CADISP) Study Group. Antiplatelets versus anticoagulation in cervical artery dissection. Stroke. 2007 Sep;38(9):2605-11. doi: 10.1161/STROKEAHA.107.489666. Epub 2007 Jul 26.

Reference Type BACKGROUND
PMID: 17656656 (View on PubMed)

Debette S, Metso TM, Pezzini A, Engelter ST, Leys D, Lyrer P, Metso AJ, Brandt T, Kloss M, Lichy C, Hausser I, Touze E, Markus HS, Abboud S, Caso V, Bersano A, Grau A, Altintas A, Amouyel P, Tatlisumak T, Dallongeville J, Grond-Ginsbach C; CADISP-group. CADISP-genetics: an International project searching for genetic risk factors of cervical artery dissections. Int J Stroke. 2009 Jun;4(3):224-30. doi: 10.1111/j.1747-4949.2009.00281.x.

Reference Type BACKGROUND
PMID: 19659826 (View on PubMed)

Other Identifiers

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CADISP

Identifier Type: -

Identifier Source: org_study_id

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