Using platelet expression and blood flow analysis to predict recurrent stroke risk
Platelet Expression of FcγRIIa and Arterial Hemodynamics to Predict Recurrent Stroke in Intracranial Atherosclerosi
This study is trying to see if certain blood cell markers and blood flow patterns can help predict the risk of having another stroke in people who have already had a minor stroke or a temporary stroke-like event.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 250 (estimated) |
| Ages | 30 Years and up |
| Sex | All |
| Sponsor | University of California, Los Angeles Academic / other |
| Locations | 1 site (Los Angeles, California) |
| Trial ID | NCT05518305 on ClinicalTrials.gov |
What this trial studies
This observational study aims to determine if higher levels of platelet FcγRIIa expression are associated with an increased risk of recurrent ischemic events in patients with intracranial atherosclerosis. By utilizing noninvasive CT angiography to assess blood flow dynamics and wall shear stress, the study seeks to understand how these factors contribute to platelet activation and subsequent stroke risk. The research focuses on patients who have experienced minor strokes or transient ischemic attacks, examining the relationship between platelet behavior and arterial hemodynamics. This approach may lead to more personalized treatment strategies for preventing recurrent strokes in affected individuals.
Who should consider this trial
Good fit: Ideal candidates include individuals who have experienced a minor stroke or transient ischemic attack due to intracranial atherosclerosis.
Not a fit: Patients with isolated anterior or posterior cerebral artery stenosis may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could provide a predictive tool for identifying patients at high risk for recurrent strokes, allowing for tailored preventive strategies.
How similar studies have performed: Previous studies have indicated that platelet FcγRIIa expression is linked to cardiovascular events, suggesting potential success for this novel approach in stroke prediction.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Stroke is defined as symptoms lasting \>24 hours and associated with imaging evidence of acute ischemia in the distribution of the stenotic vessel on head CT or brain MRI. Minor stroke is defined as NIHSS\<6, as used in prior studies. * Eligible TIA, defined as transient neurological symptoms lasting \<24 hours, need to be: a) accompanied by DWI abnormalities in the distribution of the stenotic artery; or b) multiple (\>1), stereotyped events associated with unequivocal ischemic symptoms (i.e. weakness, aphasia, diplopia), and attributed to the symptomatic artery. The intent of these restrictive inclusion criteria for TIA is to exclude potential stroke mimics. * ICAD should involve the intracranial carotid, middle cerebral, intracranial vertebral or basilar arteries. Isolated anterior and posterior cerebral artery stenosis is not included as it is uncommon in these locations and non-invasive criteria for high-grade ICAD are not well established for these vessels. * Stenosis 50-99% will be quantified by CTA. The criteria for 50-99% are: measured stenosis by WASID criteria (percent stenosis = (1-\[diameter stenosis/diameter normal\]) x 100%. * Age ³30; those 30-49 years of age must also have the presence of established atherosclerotic disease in another vascular bed (coronary, extracranial carotid, peripheral) or the presence of 2 or more risk factors (hypertension, diabetes mellitus, hyperlipidemia, tobacco abuse within the last 2 years). The rationale for this criterion is to exclude non-atherosclerotic vasculopathies. * Provide informed consent for participation in the study. Exclusion Criteria: * Other determined etiology or established cause of the acute stroke or TIA: atrial fibrillation, mitral stenosis, mechanical valve, intracardiac thrombus or vegetation, dilated cardiomyopathy or ejection fraction \<30%, proximal extracranial carotid or vertebral stenosis \>50%. * Contraindications to MRI, including MR-incompatible metallic implants (i.e. certain artificial cardiac valves, penile implants, other prosthesis), implanted electronic devices (i.e. pacemaker/defibrillator, neurostimulators, cochlear implants), other potentially mobile ferromagnetic material (i.e. shrapnel, magnetic aneurysm clips), pregnancy (women in fertile age should have a negative pregnancy test), lactation, morbid obesity, and severe claustrophobia.
Where this trial is running
Los Angeles, California
- Ronald Reagan UCLA Medical Center — Los Angeles, California, United States (Recruiting)
Study contacts
- Study coordinator: David Liebeskind, MD
- Email: dliebeskind@mednet.ucla.edu
- Phone: (310) 963-5539
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.