Overview

Heart and brain vascular ischemic disease is the leading cause of death in Spain. Risk factors play a pivotal role in the development of atherosclerosis; hypertension increases with age and is the most prevalent risk factor in CAD and stroke patients. It is also involved in comorbidities such as kidney failure, dementia and peripheral artery disease that negatively affect prognosis. Physicians are still faced with challenges in predicting outcomes and in tailoring treatment to subsets of patients, especially those underrepresented in clinical trials, such as the elderly. The aim is to identify biomarkers of endothelial function, thrombosis, genetic variants and the treatment protocols that improve prediction of prognosis models after stroke and ACS.

Project 1:
Biomarkers of prognosis for ACS without ST elevation (NSTEACS). Coordinator: J Sanchis

Our aims are to investigate the benefit of the invasive strategy in patients with NSTEACS and comorbidities, who are usually excluded from clinical trials, and to identify new biomarkers such as endothelial-derived microparticles (EDM), platelet polymorphisms and coagulation factors in predicting clinical outcomes. The project will use platelet and megakaryocyte proteomics to unveil new molecular mechanisms involved in interactions of drugs used in NSTEACS. NSTEACS patients older than 70 years, with comorbidities, will be included and randomized to routine coronary angiogram or only coronary angiogram if recurrent or inducible ischemia. One-year end point: death, reinfarction or cardiac-related readmissions.

Project 2:
Predictive function & biomarkers for patients with cerebrovascular diseases: The BASICMAR Registry. Coordinator: J Roquer

The clinical evolution and outcome of stroke strongly impacts healthcare resources. BASICMAR is an ongoing prospective register of acute stroke patients (current n=3,900), in which serum and DNA are collected. Clinical follow-up is 3, 6, 12, and 48 months. Neuroimaging, neurosonographic data and dietary questionnaires provide acute-phase in stroke cases, who will be compared to age-and sex-matched controls for blood protein and genetic biomarkers (e.g., d-dimer, tissular factor, vWillebrand factor, GWAs and epigenetic analyses). Clinical strategies will be analysed in hidden atrial fibrillation in cryptogenic stroke to designing predictive stroke models. The role of ion channels variants in stroke occurrence and its association with hypertension is also being explored.

“Hearts^©” by Phil Sanders of the Engineering Group, Gene Network, of the Centre for Genome Regulation (CRG: Centro de Regulación Genómica), awarded first prize in the El.lipse photo contest.