Chinese Atherosclerosis Risk Evaluation- Phase II

NCT ID: NCT02017756

Last Updated: 2013-12-23

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

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-01-31

Study Completion Date

2014-12-31

Brief Summary

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Stroke is the first and the fourth leading cause of death in the United States and China, respectively. Disruption of cerebrovascular vulnerable atherosclerotic plaque is the major etiology of ischemic stroke. Therefore, early detection and treatment of vulnerable plaques occurring at the feeding arteries to brain (cerebral arteries) will be helpful for prevention of stroke.

Atherosclerosis is a systemic disease that usually affects multiple vascular beds. Previous studies have shown that these high risk lesions in different segments of cerebral arteries (intracranial and extracranial arteries) might be racially specific. It is reported that, in stroke patients, intracranial vulnerable plaques are prevalent in Asian populations whereas atherosclerosis more frequently involves extracranial carotid arteries in American subjects. However, these findings are based on angiographic imaging approaches via measuring arterial luminal stenosis. Because the atherosclerotic plaque often appears as outward expansion, namely positive remodeling during progression, measuring luminal stenosis will underestimate the disease severity. Hence, directly viewing the plaque in the vessel wall is strongly suggested in order to objectively evaluate the cerebrovascular vulnerable plaque.

High resolution, black-blood magnetic resonance (MR) imaging has been widely used to accurately characterize carotid vulnerable plaque in the last two decades. The aim of using MR black-blood techniques is to suppress the blood signal (black) to enhance the signal contrast between the vessel wall and blood in the arterial lumen. Excellent agreement has been achieved between MR imaging and histology in identification of plaque components, such as intraplaque hemorrhage and lipid core. For assessing carotid plaque, MR imaging is superior to computed tomography and ultrasound imaging techniques due to its advantages including noninvasive imaging, lack of ionizing radiation, excellent soft tissue resolution, and multi-parametric image acquisition.

The Investigators hypothesize that there are specific characteristics in carotid vulnerable plaques in Chinese patients with ischemic cerebrovascular events such as ischemic stroke and transient ischemic attack (TIA). This study seeks to investigate the characteristics of vulnerable plaque in carotid arteries using high resolution, black-blood MR imaging in patients with recent TIA or ischemic stroke.

This is a cross-sectional, multicenter study. A total of 1000 patients will be recruited from more than 10 different hospitals across China within 3 years. All patients will undergo MR imaging for brain and carotid arteries within two weeks after symptom onset. The prevalence of carotid vulnerable plaque and its correlations with brain ischemic lesions, traditional risk factors, and regional distribution of China will be determined.

Detailed Description

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Conditions

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Ischemic Stroke Transient Ischemic Attack Carotid Atherosclerotic Disease

Keywords

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Carotid artery Atherosclerosis Vulnerable plaque Magnetic resonance imaging Arterial wall

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Eligibility Criteria

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Inclusion Criteria

* Patients with recent TIA of ischemic stroke (2 weeks) and carotid plaque determined by ultrasound will be included in this study.

Exclusion Criteria

* Patients with contraindications to MR scan
* Patients with hemorrhagic stroke
* Patients with evidence of cardiogenic stroke
* Patients with brain tumors
* Patients underwent carotid revascularization therapy, such as stenting and endarterectomy
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tsinghua University

OTHER

Sponsor Role lead

Responsible Party

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Chun Yuan

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Chun Yuan, PhD

Role: PRINCIPAL_INVESTIGATOR

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University

Locations

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Department of Radiology, Peking University First Hospital

Beijing, , China

Site Status RECRUITING

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University

Beijing, , China

Site Status RECRUITING

Department of Radiology, Beijing Hospital

Beijing, , China

Site Status RECRUITING

Department of Radiology, PLA General Hospital

Beijing, , China

Site Status RECRUITING

Department of Radiology, Fujian Medical University Union Hospital

Fuzhou, , China

Site Status RECRUITING

Department of Radiology, Sun Yat-Sen Memorial Hospital

Guangzhou, , China

Site Status RECRUITING

Department of Radiology, Zhujiang Hospital of Southern Medical University

Guangzhou, , China

Site Status RECRUITING

Department of Radiology, Harbin University The Fourth Affiliated Hospital

Harbin, , China

Site Status RECRUITING

Shandong Medical Imaging Research Institute

Jinan, , China

Site Status RECRUITING

Department of Radiology, Nanjing Drum Tower Hospital

Nanjing, , China

Site Status RECRUITING

Department of Radiology, The First Hospital of Qiqihaer City

Qiqihar, , China

Site Status RECRUITING

Department of Radiology, Shanghai Renji Hospital

Shanghai, , China

Site Status RECRUITING

Department of Radiology, Tianjin Fourth Centre Hospital

Tianjin, , China

Site Status RECRUITING

Department of Radiology, Qinghai University Affiliated Hospital

Xining, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xihai Zhao, MD, PhD

Role: CONTACT

Phone: 861062792662

Email: [email protected]

Rui Li, PhD

Role: CONTACT

Phone: 861062785758

Email: [email protected]

Facility Contacts

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Feiyu Li, MD, PhD

Role: primary

Le He, MD

Role: primary

Yan Song, MD, PhD

Role: primary

Xu Han, MD

Role: primary

Yunjing Xue, MD, PhD

Role: primary

Mingwei Xie, MD

Role: primary

Jing Zhang, MD

Role: primary

Yang Ji, MD

Role: primary

Honglu Shi, MD

Role: primary

Maoxue Wang, MD

Role: primary

Zhong Zhuang, MD

Role: primary

Huilin Zhao, MD

Role: primary

Xiao Gao, MD

Role: primary

Yuntai Cao, MD

Role: primary

References

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Liu L, Wang D, Wong KS, Wang Y. Stroke and stroke care in China: huge burden, significant workload, and a national priority. Stroke. 2011 Dec;42(12):3651-4. doi: 10.1161/STROKEAHA.111.635755. Epub 2011 Nov 3.

Reference Type BACKGROUND
PMID: 22052510 (View on PubMed)

Wong KS, Li H, Chan YL, Ahuja A, Lam WW, Wong A, Kay R. Use of transcranial Doppler ultrasound to predict outcome in patients with intracranial large-artery occlusive disease. Stroke. 2000 Nov;31(11):2641-7. doi: 10.1161/01.str.31.11.2641.

Reference Type BACKGROUND
PMID: 11062288 (View on PubMed)

Saam T, Underhill HR, Chu B, Takaya N, Cai J, Polissar NL, Yuan C, Hatsukami TS. Prevalence of American Heart Association type VI carotid atherosclerotic lesions identified by magnetic resonance imaging for different levels of stenosis as measured by duplex ultrasound. J Am Coll Cardiol. 2008 Mar 11;51(10):1014-21. doi: 10.1016/j.jacc.2007.10.054.

Reference Type BACKGROUND
PMID: 18325441 (View on PubMed)

Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987 May 28;316(22):1371-5. doi: 10.1056/NEJM198705283162204.

Reference Type BACKGROUND
PMID: 3574413 (View on PubMed)

Cai JM, Hatsukami TS, Ferguson MS, Small R, Polissar NL, Yuan C. Classification of human carotid atherosclerotic lesions with in vivo multicontrast magnetic resonance imaging. Circulation. 2002 Sep 10;106(11):1368-73. doi: 10.1161/01.cir.0000028591.44554.f9.

Reference Type BACKGROUND
PMID: 12221054 (View on PubMed)

Yuan C, Mitsumori LM, Ferguson MS, Polissar NL, Echelard D, Ortiz G, Small R, Davies JW, Kerwin WS, Hatsukami TS. In vivo accuracy of multispectral magnetic resonance imaging for identifying lipid-rich necrotic cores and intraplaque hemorrhage in advanced human carotid plaques. Circulation. 2001 Oct 23;104(17):2051-6. doi: 10.1161/hc4201.097839.

Reference Type BACKGROUND
PMID: 11673345 (View on PubMed)

Saam T, Cai JM, Cai YQ, An NY, Kampschulte A, Xu D, Kerwin WS, Takaya N, Polissar NL, Hatsukami TS, Yuan C. Carotid plaque composition differs between ethno-racial groups: an MRI pilot study comparing mainland Chinese and American Caucasian patients. Arterioscler Thromb Vasc Biol. 2005 Mar;25(3):611-6. doi: 10.1161/01.ATV.0000155965.54679.79. Epub 2005 Jan 13.

Reference Type BACKGROUND
PMID: 15653565 (View on PubMed)

Shao S, Sun Y, Shi H, Li R, Sun Q, Yao B, Watase H, Hippe DS, Yuan C, Wang G, Zhang Q, Zhao X; Investigators of CARE-II Study. Metabolically Abnormal Obesity and Carotid Plaque Vulnerability: A Vessel Wall MRI Study Linking Obesity Phenotypes to Atherosclerotic Instability. Arterioscler Thromb Vasc Biol. 2025 Sep 18. doi: 10.1161/ATVBAHA.125.323413. Online ahead of print.

Reference Type DERIVED
PMID: 40964717 (View on PubMed)

Meddings Z, Rundo L, Sadat U, Zhao X, Teng Z, Graves MJ. Robustness and classification capabilities of MRI radiomic features in identifying carotid plaque vulnerability. Br J Radiol. 2024 May 29;97(1158):1118-1124. doi: 10.1093/bjr/tqae057.

Reference Type DERIVED
PMID: 38711198 (View on PubMed)

Shao S, Shi H, Wang G, Li R, Sun Q, Yao B, Watase H, Hippe DS, Yuan C, Zhao X; Investigators of CARE-II study. Differences in left and right carotid plaque vulnerability in patients with bilateral carotid plaques: a CARE-II study. Stroke Vasc Neurol. 2023 Aug;8(4):284-291. doi: 10.1136/svn-2022-001937. Epub 2023 Jan 3.

Reference Type DERIVED
PMID: 36596656 (View on PubMed)

Baylam Geleri D, Watase H, Chu B, Chen L, Zhao H, Zhao X, Hatsukami TS, Yuan C; CARE-II Study Collaborators. Detection of Advanced Lesions of Atherosclerosis in Carotid Arteries Using 3-Dimensional Motion-Sensitized Driven-Equilibrium Prepared Rapid Gradient Echo (3D-MERGE) Magnetic Resonance Imaging as a Screening Tool. Stroke. 2022 Jan;53(1):194-200. doi: 10.1161/STROKEAHA.120.032505. Epub 2021 Sep 30.

Reference Type DERIVED
PMID: 34587796 (View on PubMed)

Jiang C, Zhang J, Zhu J, Wang X, Wen Z, Zhao X, Yuan C; CARE-II Investigators. Association between coexisting intracranial artery and extracranial carotid artery atherosclerotic diseases and ipsilateral cerebral infarction: a Chinese Atherosclerosis Risk Evaluation (CARE-II) study. Stroke Vasc Neurol. 2021 Dec;6(4):595-602. doi: 10.1136/svn-2020-000538. Epub 2021 Apr 26.

Reference Type DERIVED
PMID: 33903178 (View on PubMed)

Yang D, Ji Y, Wang D, Watase H, Hippe DS, Zhao X, Yuan C. Comparison of carotid atherosclerotic plaques between subjects in Northern and Southern China: a Chinese atherosclerosis risk evaluation study. Stroke Vasc Neurol. 2020 Jun;5(2):138-145. doi: 10.1136/svn-2019-000288. Epub 2020 Jan 29.

Reference Type DERIVED
PMID: 32404502 (View on PubMed)

Liu Y, Wang M, Zhang B, Wang W, Xu Y, Han Y, Yuan C, Zhao X. Size of carotid artery intraplaque hemorrhage and acute ischemic stroke: a cardiovascular magnetic resonance Chinese atherosclerosis risk evaluation study. J Cardiovasc Magn Reson. 2019 Jul 1;21(1):36. doi: 10.1186/s12968-019-0548-1.

Reference Type DERIVED
PMID: 31262337 (View on PubMed)

Zhou C, Yuan C, Li R, Wang W, Li C, Zhao X; CARE-II Study Collaborators. Association Between Incomplete Circle of Willis and Carotid Vulnerable Atherosclerotic Plaques. Arterioscler Thromb Vasc Biol. 2018 Nov;38(11):2744-2749. doi: 10.1161/ATVBAHA.118.311797.

Reference Type DERIVED
PMID: 30354232 (View on PubMed)

Zhao X, Li R, Hippe DS, Hatsukami TS, Yuan C; CARE-II Investigators. Chinese Atherosclerosis Risk Evaluation (CARE II) study: a novel cross-sectional, multicentre study of the prevalence of high-risk atherosclerotic carotid plaque in Chinese patients with ischaemic cerebrovascular events-design and rationale. Stroke Vasc Neurol. 2017 Feb 24;2(1):15-20. doi: 10.1136/svn-2016-000053. eCollection 2017 Mar.

Reference Type DERIVED
PMID: 28959486 (View on PubMed)

Zhao X, Hippe DS, Li R, Canton GM, Sui B, Song Y, Li F, Xue Y, Sun J, Yamada K, Hatsukami TS, Xu D, Wang M, Yuan C; CARE-II Study Collaborators. Prevalence and Characteristics of Carotid Artery High-Risk Atherosclerotic Plaques in Chinese Patients With Cerebrovascular Symptoms: A Chinese Atherosclerosis Risk Evaluation II Study. J Am Heart Assoc. 2017 Aug 14;6(8):e005831. doi: 10.1161/JAHA.117.005831.

Reference Type DERIVED
PMID: 28862936 (View on PubMed)

Other Identifiers

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Tsinghua-985

Identifier Type: -

Identifier Source: org_study_id