Athero-Express
Patients eligible to undergo endarterectomy of the carotid or femoral artery to treat atherosclerotic disease in the University Medical Center Utrecht (and in the past the Antonius Hospital Nieuwegein) are included in the Athero_Express study. The current number of included AE patients is over 3500, some 2,400 patients underwent carotid endarterectomy, almost 700 "femoral" patients had surgery, and well over 70 other types of arteries were operated on. In all over 430 patients were operated for various types of aneurysms, the majority being abdominal aortic aneuryms. All patients are followed for a minimum of three years. For the original study design we refer to the the article by Verhoeven et al. (PMID: 15678794).
The biobank database encompasses many characteristics: pathological specifications, clinical characteristics, 3 years follow up, whole transcriptome analyses (n=700), whole genome methylation profile (n=700) and SNP data (n=2000), single cell sequencing data (n=45)
In Athero-Express, we discovered, among other things:
- That the composition of a plaque is predictive of the development of restenosis of the treated vascular segment (JAMA 2008)
- That expression of specific proteins in a plaque can predict whether the patient is at risk for a serious cardiovascular event in any other vascular area. (papers in Circulation, ATVB, Eur Heart J).
- That the composition of the atherosclerotic plaques that lead to a stroke have changed over the past 20 years due to changes in medication and lifestyle (Circulation 2014, Nature Rev Cardiology 2017)
- That there are large differences between men and women in the molecular and cellular composition of the plaques (Circulation 2020, several other journals).
- That results obtained in atherosclerotic genetically modified mice can only be confirmed in humans to a limited extent in genetic studies (ATVB 2016).
- A new categorization of plaques, based on transcriptomics analyses, that is strongly associated with clinical presentation and genes that change under the influence of medication (submitted Nature Comm).
In summary: in Athero-Express we have been able to influence thinking about existing dogmas in the field of arteriosclerosis with a unique amount of human data. The research aims to show that we will be able to revise the traditional view of the “vulnerable plaque” (sex-specific).
For an extensive outline of the content of the biobank and our main aims and objectives click here.