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Biomarkers as Prognostic Factors of Silent, Cerebral Infarctions in Patients Undergoing High-thromboembolic-risk Transcatheter Interventions (PRINCESS)

24. september 2026 opdateret af: Stergios Tzikas, Aristotle University Of Thessaloniki

Background: The transcatheter interventions with high thromboembolic risk, as transcatheter carotid angioplasty or transcatheter ablation of cardiac arrhythmias are associated with asymptomatic strokes- silent strokes. The silent strokes are cerebral infarctions with small diameter which are diagnosed with computed tomography or magnetic resonance imaging (MRI). Silent cerebral infarctions (SCIs) are associated with neurological deficits, cognitive impairment, high mortality and high risk of dementia. There are biomarkers, as neuron specific enolase (NSE) and neurofilaments (NFLs) which are indicated for the prognosis of these patients.

Aim: The aim of this study is the prognostic role of biomarkers NSE and NFLs in patients undergoing high-thromboembolic-risk transcatheter interventions. This study will assess the hypothesis that the level of these biomarkers could predict the development of SCIs and the long-term cognitive impairment.

Study type - materials: This study is a prospective, observational study. Patients undergoing highthromboembolic-risk transcatheter interventions will be included in this study.

Protocol: All the demographic and clinical characteristics of patients will be recorded. Blood samples will be obtained, 24 hours pre-interventionally and 24 hours post-interventionally. The blood samples will be centrifugated and will be freezed at -80 οC for the measurement of biomarkers. MRI will be conducted 24 hours pre- and postinterventionally. The neurological assessment will be conducted with the use of Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) questionnaires, 24 hours pre-interventionally, 24 hours and 6 months postinterventionally.

Outcomes: The primary outcome is the association between level of biomarkers and the development of SCIs in MRI post-procedurally. Secondary outcomes concern the probable association of biomarkers with the cognitive impairment. The data will be assessed with statistical analysis and will be interpreted. The results of this study will be published with the view to create algorithms and prognostic tools for appropriate management of these patients.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Anslået)

100

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Stergios Tzikas, Associate Professor of Cardiology
  • Telefonnummer: 002313312344
  • E-mail: tzikas@auth.gr

Undersøgelse Kontakt Backup

  • Navn: Alexandros Evangeliou, Resident fo Cardiology
  • Telefonnummer: 00306977598469
  • E-mail: apevange@auth.gr

Studiesteder

      • Thessaloniki, Grækenland, 54642
        • Rekruttering
        • Third Department of Cardiology, Aristotle University of Thessaloniki, Greece
        • Kontakt:
          • Stergios Tzikas, Associate Professor of Cardiology
          • Telefonnummer: 002313312344
          • E-mail: tzikas@auth.gr
        • Kontakt:
          • Alexandros Evangeliou, Resident of Cardiology
          • Telefonnummer: 00306977598469
          • E-mail: apevange@auth.gr
        • Underforsker:
          • Vassilios Vassilikos
        • Ledende efterforsker:
          • Stergios Tzikas
        • Underforsker:
          • Alexandros Evangeliou
        • Underforsker:
          • Christos Karkos

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients undergoing high-thromboembolic-risk transcatheter interventions (Carotid scenting and cardiac ablation procedure for cardiac arrhythmias.

Beskrivelse

Inclusion Criteria:

  1. Age > 18 years
  2. Signed consent
  3. Agreement on monitoring required by the study

Exclusion Criteria:

  1. Age < 18 years
  2. Patients with known malignancies
  3. Patients who are unable or unwilling to give consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: CASE_CONTROL
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Patients with new silent strokes at post-procedural MRI

Patients diagnosed with carotid artery disease who will undergo transcatheter revascularization surgery and patients with cardiac arrhythmias who will undergo transcatheter ablation procedure will be enrolled.

Patients without new silent strokes at post-procedural MRI

Patients diagnosed with carotid artery disease who will undergo transcatheter revascularization surgery and patients with cardiac arrhythmias who will undergo transcatheter ablation procedure will be enrolled.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Difference in serum neuron-specific enolase concentration between participants with and without new silent cerebral infarcts
Tidsramme: Blood sampling and brain MRI at 24 hours before and 24 hours after the procedure; comparison based on the 24-hour post-procedural NSE concentration.

In participants undergoing carotid artery stenting, serum neuron-specific enolase (NSE) concentration at 24 hours after the procedure will be compared between participants with and without new silent cerebral infarcts. NSE will be measured using an enzyme-linked immunosorbent assay (ELISA). Concentrations and the between-group difference will be expressed in ng/mL.

Blood sampling and brain MRI at 24 hours before and 24 hours after the procedure; comparison based on the 24-hour post-procedural NSE concentration.
Difference in serum neurofilament light chain concentration between participants with and without new silent cerebral infarcts
Tidsramme: Blood sampling and brain MRI at 24 hours before and 24 hours after the procedure; comparison based on the 24-hour post-procedural NfL concentration

In participants undergoing carotid artery stenting, serum neurofilament light chain (NfL) concentration at 24 hours after the procedure will be compared between participants with and without new silent cerebral infarcts. NfL will be measured using a dot blot assay. Concentrations and the between-group difference will be expressed in μg/mL.

New silent cerebral infarcts are defined as new ischemic lesions on post-procedural diffusion-weighted brain MRI that were absent on baseline MRI, without corresponding new clinical neurological symptoms.

Blood sampling and brain MRI at 24 hours before and 24 hours after the procedure; comparison based on the 24-hour post-procedural NfL concentration

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Correlation between serum neuron-specific enolase concentration and change in Montreal Cognitive Assessment score
Tidsramme: 24 hours before and 24 hours after the procedure.

The correlation between serum neuron-specific enolase (NSE) concentration at 24 hours after the procedure and the change in Montreal Cognitive Assessment (MoCA) total score will be assessed using Spearman's rank correlation coefficient.

NSE will be measured using an enzyme-linked immunosorbent assay (ELISA) and expressed in ng/mL.

MoCA total scores range from 0 to 30 points, with higher scores indicating better cognitive performance. Change will be calculated as the 24-hour post-procedural score minus the pre-procedural score; negative values indicate deterioration

24 hours before and 24 hours after the procedure.
Correlation between serum neurofilament light chain concentration and change in Montreal Cognitive Assessment score
Tidsramme: 24 hours before and 24 hours after the procedure.

The correlation between serum neurofilament light chain (NfL) concentration at 24 hours after the procedure and the change in Montreal Cognitive Assessment (MoCA) total score will be assessed using Spearman's rank correlation coefficient.

NfL will be measured using a dot blot assay and expressed in μg/mL.

MoCA total scores range from 0 to 30 points, with higher scores indicating better cognitive performance. Change will be calculated as the 24-hour post-procedural score minus the pre-procedural score; negative values indicate deterioration.

24 hours before and 24 hours after the procedure.

Samarbejdspartnere og efterforskere

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Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

10. juni 2025

Primær færdiggørelse (Anslået)

1. maj 2027

Studieafslutning (Anslået)

1. juli 2027

Datoer for studieregistrering

Først indsendt

5. december 2025

Først indsendt, der opfyldte QC-kriterier

24. september 2026

Først opslået (Faktiske)

28. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

28. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

24. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 5141

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