Clinical Parameters and Epigenetic Biomarkers of Plaque Vulnerability in Patients with Carotid Stenosis
Laia Carballo-Perich1, Dolors Puigoriol-Illamola1, Saima Bashir2
1Cerebrovascular Pathology Research Group, Girona Biomedical Research Institute (IDIBGI), RICORS-ICTUS, Parc Hospitalari Martí I Julià, Edifici M2, 17190 Salt, Spain.
Insights
Atherosclerosis in carotid arteries causes strokes. Identifying biomarkers for plaque vulnerability can improve patient selection for treatments, enhancing stroke prevention and management strategies.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Genetics
Background:
- Atherosclerosis, particularly carotid artery disease, is a leading cause of stroke and disability globally.
- Current methods for managing carotid artery atherosclerosis rely heavily on stenosis degree, leading to suboptimal patient selection for interventions.
- There is a critical need for improved diagnostic and prognostic tools, such as biomarkers, to identify vulnerable plaques and stratify stroke risk.
Purpose of the Study:
- To review current clinical parameters for managing carotid artery atherosclerosis.
- To summarize the latest advancements in epigenetic biomarkers for assessing carotid atherosclerosis and plaque vulnerability.
- To highlight the potential of biomarkers in refining patient selection for surgical or medical treatments.
Main Methods:
- Literature review focusing on clinical parameters and epigenetic biomarkers related to carotid atherosclerosis.
- Synthesis of current data on diagnostic and prognostic significance of identified biomarkers.
- Analysis of the clinical relevance of these biomarkers in routine practice.
Main Results:
- Several protein-based biomarkers show promise for diagnosing carotid artery disease and predicting prognosis, but none are clinically implemented.
- Epigenetic biomarkers are emerging as a significant area of research for understanding plaque vulnerability.
- Clinical parameters, alongside emerging biomarkers, can potentially improve the accuracy of patient risk stratification.
Conclusions:
- Improved patient selection for carotid artery interventions is crucial for reducing stroke incidence.
- Epigenetic biomarkers offer a promising avenue for identifying vulnerable atherosclerotic plaques.
- Integrating clinical parameters with novel biomarkers may lead to more personalized and effective management of carotid artery disease.
Abstract:
Atheromatous disease is the first cause of death and dependency in developed countries and carotid artery atherosclerosis is one of the main causes of severe ischaemic strokes. Current management strategies are mainly based on the degree of stenosis and patient selection has limited accuracy. This information could be complemented by the identification of biomarkers of plaque vulnerability, which would permit patients at greater and lesser risk of stroke to be distinguished, thus enabling a better selection of patients for surgical or intensive medical treatment. Although several circulating protein-based biomarkers with significance for both the diagnosis of carotid artery disease and its prognosis have been identified, at present, none have been clinically implemented. This review focuses especially on the most relevant clinical parameters to take into account in routine clinical practice and summarises the most up-to-date data on epigenetic biomarkers of carotid atherosclerosis and plaque vulnerability.
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