Trial Outcomes & Findings for Randomized Trial of Imaging Versus Risk Factor-Based Therapy for Plaque Regression (NCT NCT01212900)

NCT ID: NCT01212900

Last Updated: 2018-11-30

Results Overview

Wall volume of internal carotid arteries was measured using magnetic resonance imaging. Participants will undergo 2D and 3D carotid MRI using a 3 Tesla scanner and surface carotid coils. Participants with mild or no atherosclerosis, defined as the lowest tertile of wall volume, will have statin therapy adjusted to a target range of 100-130 mg/dL. Participants in the middle tertile will receive statin therapy adjusted to achieve a target LDL 70-100 mg/dL. Participants with the most severe atherosclerosis will receive statin therapy to an LDL target between 40 and 70 mg/dL. Participants in the Standard arm will have lipid sub-fraction targets determined according to estimated 10 year cardiovascular risk, as per standard NCEP guidelines.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

230 participants

Primary outcome timeframe

24 months

Results posted on

2018-11-30

Participant Flow

Participant milestones

Participant milestones
Measure
Imaging
Lipid targets assigned according to the severity of atherosclerotic plaque measured as wall volume in the common and internal carotid arteries by MRI
Standard
Standardized statin therapy based on NCEP ATP IIIR guidelines, including clinical risk factors and blood lipid levels.
Overall Study
STARTED
116
114
Overall Study
COMPLETED
104
107
Overall Study
NOT COMPLETED
12
7

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Randomized Trial of Imaging Versus Risk Factor-Based Therapy for Plaque Regression

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Imaging
n=116 Participants
Lipid targets assigned according to the severity of atherosclerotic plaque measured as wall volume in the common and internal carotid arteries by MRI
Standard
n=114 Participants
Standardized statin therapy based on NCEP ATP IIIR guidelines, including clinical risk factors and blood lipid levels.
Total
n=230 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
61 Participants
n=5 Participants
51 Participants
n=7 Participants
112 Participants
n=5 Participants
Age, Categorical
>=65 years
55 Participants
n=5 Participants
63 Participants
n=7 Participants
118 Participants
n=5 Participants
Sex: Female, Male
Female
47 Participants
n=5 Participants
45 Participants
n=7 Participants
92 Participants
n=5 Participants
Sex: Female, Male
Male
69 Participants
n=5 Participants
69 Participants
n=7 Participants
138 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
4 Participants
n=7 Participants
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
115 Participants
n=5 Participants
110 Participants
n=7 Participants
225 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Asian
3 Participants
n=5 Participants
5 Participants
n=7 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
6 Participants
n=5 Participants
11 Participants
n=7 Participants
17 Participants
n=5 Participants
Race (NIH/OMB)
White
105 Participants
n=5 Participants
95 Participants
n=7 Participants
200 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 24 months

Population: The analyses included only those subjects who were assigned standardized statin doses based on imaging of carotids at baseline based on NCEP ATP IIIR guidelines.

Wall volume of internal carotid arteries was measured using magnetic resonance imaging. Participants will undergo 2D and 3D carotid MRI using a 3 Tesla scanner and surface carotid coils. Participants with mild or no atherosclerosis, defined as the lowest tertile of wall volume, will have statin therapy adjusted to a target range of 100-130 mg/dL. Participants in the middle tertile will receive statin therapy adjusted to achieve a target LDL 70-100 mg/dL. Participants with the most severe atherosclerosis will receive statin therapy to an LDL target between 40 and 70 mg/dL. Participants in the Standard arm will have lipid sub-fraction targets determined according to estimated 10 year cardiovascular risk, as per standard NCEP guidelines.

Outcome measures

Outcome measures
Measure
Imaging
n=91 Participants
Lipid targets assigned according to the severity of atherosclerotic plaque measured as wall volume in the common and internal carotid arteries by MRI
Standard
n=89 Participants
Standardized statin therapy based on NCEP ATP IIIR guidelines, including clinical risk factors and blood lipid levels.
Change in Mean of Wall Volume of Internal Carotid Arteries
-3.52 Other - mm^3 ( cubic millimeter )
Interval -7.552305 to 0.506032
-5.91 Other - mm^3 ( cubic millimeter )
Interval -10.9683601 to -0.8536061

Adverse Events

Imaging

Serious events: 18 serious events
Other events: 58 other events
Deaths: 0 deaths

Standard

Serious events: 18 serious events
Other events: 51 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Imaging
n=116 participants at risk
Lipid targets assigned according to the severity of atherosclerotic plaque measured as wall volume in the common and internal carotid arteries by MRI
Standard
n=114 participants at risk
Standardized statin therapy based on NCEP ATP IIIR guidelines, including clinical risk factors and blood lipid levels.
Cardiac disorders
Acute myocardial infarction
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Cardiac disorders
Coronary artery disease
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Gastrointestinal disorders
Gastrointestinal haemorrhage
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Gastrointestinal disorders
Pancreatitis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
General disorders
Death
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Infections and infestations
Cellulitis
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Infections and infestations
Pneumonia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Injury, poisoning and procedural complications
accidental overdose
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Injury, poisoning and procedural complications
Concussion
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Investigations
Blood creatine abnormal
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Investigations
Haemoglobin abnormal
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Investigations
Hepatic enzyme abnormal
0.86%
1/116 • 24 months
2.6%
3/114 • 24 months
Investigations
Hospitalisation
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
adenocarcinoma
0.86%
1/116 • 24 months
0.88%
1/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Biopsy skin
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Gingival cancer
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung neoplasm malignant
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Oral neoplasm
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Nervous system disorders
Spinal cord herniation
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Psychiatric disorders
Amnesia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Epiglottitis
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Aortic surgery
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Arthroscopic surgery
2.6%
3/116 • 24 months
2.6%
3/114 • 24 months
Surgical and medical procedures
Breast conserving surgery
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Cardiac ablation
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Coronary arterial stent insertion
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Elective procedure
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Hospitalisation
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Prostatectomy
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Thyroidectomy
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Transurethral prostatectomy
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Uterine prolapse repair
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Vascular disorders
Carotid artery aneurysm
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months

Other adverse events

Other adverse events
Measure
Imaging
n=116 participants at risk
Lipid targets assigned according to the severity of atherosclerotic plaque measured as wall volume in the common and internal carotid arteries by MRI
Standard
n=114 participants at risk
Standardized statin therapy based on NCEP ATP IIIR guidelines, including clinical risk factors and blood lipid levels.
Blood and lymphatic system disorders
Anaemia
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Blood and lymphatic system disorders
Hyperbilirubinaemia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Blood and lymphatic system disorders
Lymphadenopathy
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Cardiac disorders
Chest discomfort
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Cardiac disorders
Dyspnoea
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Cardiac disorders
Palpitations
1.7%
2/116 • 24 months
0.88%
1/114 • 24 months
Cardiac disorders
Presyncope
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Ear and labyrinth disorders
External ear pain
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Ear and labyrinth disorders
Hypoacusis
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Ear and labyrinth disorders
Otitis externa
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Ear and labyrinth disorders
Tinnitus
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Ear and labyrinth disorders
Vertigo
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Endocrine disorders
Goitre
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Endocrine disorders
Hypothyroidism
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Eye disorders
Dry eye
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Eye disorders
Retinal haemorrhage
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Eye disorders
Visual impairment
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Gastrointestinal disorders
Diarrhoea
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Gastrointestinal disorders
Dry mouth
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Gastrointestinal disorders
Dysphagia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Gastrointestinal disorders
Gastritis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Gastrointestinal disorders
Gastrointestinal pain
0.86%
1/116 • 24 months
0.88%
1/114 • 24 months
Gastrointestinal disorders
Glossodynia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Gastrointestinal disorders
nausea
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
General disorders
Chest pain
1.7%
2/116 • 24 months
0.00%
0/114 • 24 months
General disorders
fatigue
2.6%
3/116 • 24 months
2.6%
3/114 • 24 months
General disorders
Nodule
0.00%
0/116 • 24 months
1.8%
2/114 • 24 months
General disorders
Oedema
1.7%
2/116 • 24 months
0.00%
0/114 • 24 months
Hepatobiliary disorders
Haemangioma of liver
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Infections and infestations
Genitourinary tract infection
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Infections and infestations
Herpes zoster
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Infections and infestations
Infection
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Infections and infestations
Pneumonia
0.86%
1/116 • 24 months
0.88%
1/114 • 24 months
Infections and infestations
Sinusitis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Injury, poisoning and procedural complications
Muscle strain
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Injury, poisoning and procedural complications
Spinal cord herniation
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Investigations
Alanine aminotransferase increased
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Investigations
Blood creatine abnormal
0.00%
0/116 • 24 months
1.8%
2/114 • 24 months
Investigations
Blood pressure increased
0.86%
1/116 • 24 months
2.6%
3/114 • 24 months
Investigations
Intraocular pressure increased
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Investigations
Low density lipoprotein increased
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Investigations
Pregnancy test false positive
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Metabolism and nutrition disorders
Hypoglycaemia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Metabolism and nutrition disorders
Oedema peripheral
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Arthritis
3.4%
4/116 • 24 months
0.88%
1/114 • 24 months
Musculoskeletal and connective tissue disorders
Back pain
1.7%
2/116 • 24 months
1.8%
2/114 • 24 months
Musculoskeletal and connective tissue disorders
Fracture
1.7%
2/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Joint stiffness
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Muscle contractions involuntary
2.6%
3/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Muscle rupture
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Muscular weakness
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Musculoskeletal stiffness
0.86%
1/116 • 24 months
0.88%
1/114 • 24 months
Musculoskeletal and connective tissue disorders
myalgia
2.6%
3/116 • 24 months
4.4%
5/114 • 24 months
Musculoskeletal and connective tissue disorders
Osteoarthritis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Pain
1.7%
2/116 • 24 months
1.8%
2/114 • 24 months
Musculoskeletal and connective tissue disorders
Pain in extremity
1.7%
2/116 • 24 months
0.88%
1/114 • 24 months
Musculoskeletal and connective tissue disorders
Rotator cuff repair
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Tendon discomfort
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Tendon pain
1.7%
2/116 • 24 months
0.00%
0/114 • 24 months
Musculoskeletal and connective tissue disorders
Tendonitis
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Musculoskeletal and connective tissue disorders
Upper limb fracture
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Cyst
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Nervous system disorders
Balance disorder
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Nervous system disorders
Facial paralysis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Nervous system disorders
Facial spasm
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Nervous system disorders
Headache
0.00%
0/116 • 24 months
1.8%
2/114 • 24 months
Nervous system disorders
Neuropathy peripheral
0.00%
0/116 • 24 months
1.8%
2/114 • 24 months
Nervous system disorders
Paraesthesia
0.00%
0/116 • 24 months
2.6%
3/114 • 24 months
Nervous system disorders
Parkinson&#39;s disease
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Nervous system disorders
Tremor
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Nervous system disorders
Trigeminal neuralgia
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Psychiatric disorders
Amnesia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Psychiatric disorders
Anxiety
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Psychiatric disorders
Insomnia
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Renal and urinary disorders
Flank pain
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Renal and urinary disorders
Nephrolithiasis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Renal and urinary disorders
Urinary tract infection
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Adductor vocal cord weakness
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Adenoviral upper respiratory infection
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Bronchitis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Chest discomfort
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Chronic sinusitis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
cough
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Dyspnoea exertional
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Nasal congestion
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Pulmonary fibrosis
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Pulmonary sarcoidosis
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Respiratory, thoracic and mediastinal disorders
Upper respiratory tract infection
0.86%
1/116 • 24 months
1.8%
2/114 • 24 months
Skin and subcutaneous tissue disorders
Alopecia
0.00%
0/116 • 24 months
1.8%
2/114 • 24 months
Surgical and medical procedures
Acupuncture
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Antidepressant therapy
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Breast operation
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Cyst drainage
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Finger amputation
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Hernia repair
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Meniscus operation
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Radioactive iodine therapy
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Surgical and medical procedures
Rotator cuff repair
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Tendon operation
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Surgical and medical procedures
Vocal cord polypectomy
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months
Vascular disorders
Hypertension
0.86%
1/116 • 24 months
0.00%
0/114 • 24 months
Vascular disorders
Intermittent claudication
0.00%
0/116 • 24 months
0.88%
1/114 • 24 months

Additional Information

Mehta, Nehal

National Heart Lung and Blood Institute

Phone: +1 301 827 0483

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place