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3 results on '"Vulnerability biomarkers"'

1. Computed Tomography Biomarkers of Vulnerable Coronary Plaques

Author

Nyulas Tiberiu, Chiţu Monica, Mester András, Jáni Laura, Condrea Sebastian, Opincariu Diana, Kovács István, Benedek Imre, and Benedek Theodora

Subjects
unstable plaque, vulnerability biomarkers, cta, vh-ivus, oct, Medicine
Abstract

An unstable plaque has a high risk of thrombosis and at the same time for a fast progression of the stenosis degree. Also, “high-risk plaque” and “thrombosis-prone plaque” are used as synonym terms for characterization of a vulnerable plaque. The imaging biomarkers for vulnerable coronary plaques are considered to be spotty calcifications, active remodeling, low-density atheroma and the presence of a ring-like attenuation pattern, also known as the napkin-ring sign. Computed cardiac tomography can determine the plaque composition by assessing the plaque density, which is measured in Hounsfield units (HU). The aim of this manuscript was to provide an update about the most frequently used biomarkers of vulnerability in a vulnerable plaque with the help of computed cardiac tomography. more...

Published
2016
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2. Deferred Urgency Carotid Artery Stenting in Symptomatic Patients: Clinical Lessons and Biomarker Patterns from a Prospective Registry.

Author

Setacci, C., de Donato, G., Chisci, E., Setacci, F., Stella, A., Faggioli, G., Reimers, B., Cernetti, C., Lopera Quijada, M.J., Cappi, B., and Sangiorgi, G.

Subjects
HEALTH risk assessment, CAROTID artery, BLOOD plasma, BIOMARKERS
Abstract

Introduction: The aim of this prospective observational registry was to study the outcome of symptomatic patients presenting with recent TIA or minor stroke and severe carotid stenosis, submitted to early percutaneous treatment by stenting. A secondary aim was to evaluate the biological activity of the symptomatic carotid plaques by serial serum and urinary markers (PAPP-A, hs-CRP, MMP-2/MMP-9, IL-6/IL-8, TNF alpha, CD40L) measured by enzyme-linked immunosorbent assay before and after treatment. Methods: From May 2005 to June 2006, 57 patients were enrolled in this prospective registry. All patients underwent carotid stenting using a concentric filter for cerebral protection. The procedure was performed within 24–48hrs of the last attack in patients with TIA (n =24, 42%) and between 14 and 30 days in patients with stroke (n =33, 58%). Results: Successful stent implantation was achieved in all cases (100%). Adverse events at 1 month were 1 death (1.7%) and 2 TIAs (3.5%). Some of the vulnerability markers, in particular those reflecting an active systemic inflammatory process of the plaque (PAPP-A, hs-CR, and IL-6), were significantly elevated at the time of enrolment, increased after stenting and decreased after 30 days. Conclusion: Deferred CAS is feasible and safe in selected patients with symptomatic carotid stenosis. This preliminary study in a limited series of patients with unstable carotid plaques revealed that endovascular treatment has a satisfactory outcome considering the very high risk profile of the patient population. The evaluation of some biomarkers suggested an inflammatory role in the process of an unstable carotid plaque generating an acute cerebral event. [Copyright &y& Elsevier] more...

Published
2008
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3. Deferred urgency carotid artery stenting in symptomatic patients: clinical lessons and biomarker patterns from a prospective registry

Author

C. Setacci, G. d. Donato, E. Chisci, F. Setacci, B. Reimers, C. Cernetti, M. J. Lopera, B. Cappi, G. Sangiorgi, S. R. Group, STELLA, ANDREA, FAGGIOLI, GIANLUCA, C. Setacci, G. d. Donato, E. Chisci, F. Setacci, A. Stella, G. Faggioli, B. Reimer, C. Cernetti, M. J. Lopera, B. Cappi, G. Sangiorgi, and S. R. Group more...

Subjects
Male, etiology/metabolism/mortality/therapy, Italy, Male, Matrix Metalloproteinase 2, Percutaneous, Time Factors, medicine.medical_treatment, Deferred urgency carotid artery stenting, Pilot Projects, Severity of Illness Index, Symptomatic carotid stenosis, Medicine, Pregnancy-Associated Plasma Protein-A, Carotid Stenosis, Prospective Studies, Registries, Prospective cohort study, Stroke, adverse effects/instrumentation, Biological Marker, Aged, Aged, Medicine(all), Aged, 80 and over, Transient, Unstable carotid plaque, metabolism, Patient Selection, Pilot Projects, Pregnancy-Associated Plasma Protein-A, metabolism, Carotid Stenosi, complications/metabolism/mortality/therapy, Enzyme-Linked Immunosorbent Assay, Feasibility Studies, Female, Humans, Interleukin-6, metabolism, CD40 Ligand, C-Reactive Protein, Treatment Outcome, Italy, Matrix Metalloproteinase 9, Ischemic Attack, Transient, Matrix Metalloproteinase 2, Female, Stents, Cardiology and Cardiovascular Medicine, Vulnerability biomarkers, metabolism, Matrix Metalloproteinase 9, medicine.medical_specialty, metabolism, Interleukin-8, CD40 Ligand, Enzyme-Linked Immunosorbent Assay, Prosthesis Design, Risk Assessment, 80 and over, Angioplasty, Angioplasty, Severity of illness, Humans, blood/metabolism/urine, C-Reactive Protein, cardiovascular diseases, metabolism, Ischemic Attack, Aged, metabolism, Prospective Studies, Prosthesis Design, Registries, Risk Assessment, Severity of Illness Index, Stents, Stroke, business.industry, Interleukin-6, Tumor Necrosis Factor-alpha, Patient Selection, Interleukin-8, etiology/metabolism/mortality/therapy, Time Factors, Treatment Outcome, Tumor Necrosis Factor-alpha, medicine.disease, Surgery, Clinical trial, Stenosis, Feasibility Studies, Carotid stenting, business, metabolism, Balloon, Angioplasty, Balloon, Biomarkers
Abstract

Introduction The aim of this prospective observational registry was to study the outcome of symptomatic patients presenting with recent TIA or minor stroke and severe carotid stenosis, submitted to early percutaneous treatment by stenting. A secondary aim was to evaluate the biological activity of the symptomatic carotid plaques by serial serum and urinary markers (PAPP-A, hs-CRP, MMP-2/MMP-9, IL-6/IL-8, TNF alpha, CD40L) measured by enzyme-linked immunosorbent assay before and after treatment. Methods From May 2005 to June 2006, 57 patients were enrolled in this prospective registry. All patients underwent carotid stenting using a concentric filter for cerebral protection. The procedure was performed within 24–48hrs of the last attack in patients with TIA ( n =24, 42%) and between 14 and 30 days in patients with stroke ( n =33, 58%). Results Successful stent implantation was achieved in all cases (100%). Adverse events at 1 month were 1 death (1.7%) and 2 TIAs (3.5%). Some of the vulnerability markers, in particular those reflecting an active systemic inflammatory process of the plaque (PAPP-A, hs-CR, and IL-6), were significantly elevated at the time of enrolment, increased after stenting and decreased after 30 days. Conclusion Deferred CAS is feasible and safe in selected patients with symptomatic carotid stenosis. This preliminary study in a limited series of patients with unstable carotid plaques revealed that endovascular treatment has a satisfactory outcome considering the very high risk profile of the patient population. The evaluation of some biomarkers suggested an inflammatory role in the process of an unstable carotid plaque generating an acute cerebral event. more...

Published
2007