Predictive, preventive and personalized project of vascular cognitive impairment in China (P3): Study design and interim baseline patient characteristics of a Nationwide multicenter prospective registry

Objectives: To outline the design of the P3 study and serve as a summary of the interim baseline patient characteristics.

Methods: P3 study is a multicenter, prospective cohort study targeting 1000 acute ischemic stroke (AIS) and cerebral small vessel disease (CSVD) patients with a 2-year follow-up from 80 participating hospitals across China. Comprehensive multimodal imaging, neuropsychological tests, and biological samples were collected prospectively on admission and follow-up visits. Patients were interviewed face to face for 2 years and followed up.

Results: Until 30 December 2023, 642 patients were enrolled from 67 centers. In the AIS cohort, 219 patients (72.5%) were diagnosed with acute post-stroke cognitive impairment (PSCI). Compared to those without PSCI, the acute PSCI group exhibited significantly lower levels of education and a history of stroke (all P < 0.05). In the CSVD cohort, 53 patients (41.4%) were diagnosed with cognitive impairment. Compared to those with normal cognitive function, the impaired cognitive function group had a significantly higher prevalence of hypertension and diabetes history (all P < 0.05). All 642 patients completed 20 tests, as well as clinical information and blood sample collection. Nearly 95% of the patients underwent structural MRI and ASL, and 60% of patients completed fMRI and DKI or DTI.

Conclusions: P3 study aims to establish a comprehensive spatiotemporal profile of VCI. Through multidimensional analysis of clinical information, radiomics, proteomics, metabolomics, microbiomics, and genetics, provide a more comprehensive understanding of VCI trajectories and individual variability, enhancing early detection and prognosis management.