Athero Express : ATHERO-sclerotic plaque EXPRESSion in relation to vascular events and patient characteristics

Athero-Express is a tissue bank study, designed to investigate the expression of atherosclerotic derived biological variables in relation to the long-term outcome of patients undergoing carotid endarterectomy. Its design includes both cross-sectional and follow-up studies, the results from which should expand our current knowledge of atherosclerotic disease. Due to the relatively large sample size, it should be possible to correct potential confounders whilst exploring protein and RNA expression in relation to plaque characteristics. The objectives of Athero-Express include the identification of new plaque markers, patient risk profiles and treatment strategies as well as the early detection of “patients at risk”. Follow-up studies, in which the long term outcome in relation to local protein and RNA expression are studied, will take several years to complete, due to the large sample size required to correct confounding. For this reason, cross sectional studies are likely to be undertaken in the first years of the study. Cross-sectional studies can be used to validate any proteins of interest, which, from either in vitro or in vivo studies, appear to be related to the progression of atherosclerotic disease. Future follow-up studies will focus on proteomic analyses. These, in turn, should result in the discovery of new proteins of interest. To date, Athero-Express has proved a successful bio-bank. Several cross sectional studies have already been performed. Its power is based on the large number of patients included. At this moment, proteomic analyses are being performed in Singapore. We expect mass spectrometry proteomics to reveal new, as yet unrecognised proteins, differentially expressed in 1- traditionally defined fibrous, stable plaques versus atheromatous, inflammatory.