Aneurysmal Subarachnoid Hemorrhage Clinical Trial
— EVAPROPECOfficial title:
Prognostic Value of Circulating Endothelial Progenitor Cells in Aneurysmal Subarachnoid Hemorrhage (Evaluation de l'intérêt Pronostic Des progéniteurs endothéliaux Circulants Dans l'hémorragie Sous-arachnoïdienne Par Rupture d'anévrysme cérébral)
Aneurysmal subarachnoid hemorrhage is a common and serious disease associated to a high rate
of mortality and morbidity. Severe definitive neurological impairment can concern up to 30%
of patients in relation with elevated intracranial pressure, hemorrhage recurrence and
symptomatic cerebral arterial vasospasm. This latter complication is defined as a reversible
reduction of cerebral artery's diameter occurring between the 4th and the 14th day after
bleeding. Physiopathology is not well understood, but could involve endothelium, trough
endothelial progenitor cells (EPC). Circulating EPC are bone marrow-derived cells with
capacity of vasculogenesis and angiogenesis. EPC have been recognized playing a beneficial
role in cardiovascular disease and ischemic stroke. EPC have never been studied in
aneurysmal subarachnoid hemorrhage.
The primary objective of this study is to compare the number of circulating endothelial
progenitor cells between patients with a good neurological outcome (defined as a glasgow
outcome scale = 1 or 2) and patients with a poor neurological outcome (glasgow outcome scale
= 3, 4 or 5).
Briefly, the number of circulating EPC will be measured at admission, and at day 3, 6, 10,
14, 21 in each consecutive patient suffering aneurysmal subarachnoid hemorrhage and
hospitalized in Teaching Hospital of Besançon (France). The neurological outcome will be
measured one year after subarachnoid hemorrhage.
Status | Recruiting |
Enrollment | 92 |
Est. completion date | December 2015 |
Est. primary completion date | December 2015 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - recent(< 24 h) aneurysmal subarachnoid hemorrhage - written informed consent obtained from the patient or from close relatives Exclusion Criteria: - refusal to participate - Non-aneurysmal subarachnoid hemorrhage - aneurysmal subarachnoid hemorrhage with estimated date of bleeding > 24 h - Chronic heart failure - Chronic medication able to modify the plasmatic level of BNP - Pregnancy |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
France | CHRU de Besançon | Besançon |
Lead Sponsor | Collaborator |
---|---|
Centre Hospitalier Universitaire de Besancon |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Glasgow Outcome Scale | One year after bleeding | No | |
Other | Vasospasm occurence | Vasospasm will be defined as at less one segmental narrowing of a cerebral artery diagnosed on cerebral angiography (angio scanner, angio-MRI or 4 axes cerebral arteriography). Cerebral angiography will be done as necessary according to the occurence of the following situations a clinical neurological deterioration unexplained by another cause a mean arterial blood flow speed higher than 2 m/s assessed in cerebral arteries by transcranial doppler or a significant elevation of the mean arterial blood flow speed on two consecutive evaluations |
during the 3 weeks after bleeding | No |
Primary | endothelial progenitor cells count | day 3 after bleeding | No | |
Secondary | Endothelial progenitor cells count | day 0, 6, 10, 14, 21 after bleeding | No | |
Secondary | Maximal amplitude of variation of EPC count | 3 weeks after bleeding | No | |
Secondary | Plasmatic brain natriuretic peptide | day 0, 3, 6, 10, 14, 21 after bleeding | No |
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