Individualized Physical Activity and Carotid Plaque Instability

NCT ID: NCT04053166

Last Updated: 2025-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-03

Study Completion Date

2022-09-21

Brief Summary

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Intraplaque hemorrhage (IPH) is one of the main features of the carotid plaque instability's and predictor of ischemic stroke. Benefits (on the basis on benefit/risk ratio) of the carotid endarterectomy remain unclear for stroke asymptomatic patients; thus, more and more patients with important stenosis (i.e. over 60%) detected are not operated. However, these patients need adapted therapeutic treatments to limit plaque instability and this should include physical activity (PA). Indeed, PA has been showed to decrease numerous inflammatory markers involved in atherosclerosis. It has also recently been reported on stroke asymptomatic patients that the prevalence of carotid IPH was decreased in those with higher level of PA. Magnetic Resonance Imaging (MRI) of the IPH has been shown to be the better non-invasive imaging technique to assess carotid plaque instability and in particular IPH. Here, the aim of this study is to assess the effect of an individualized home-based 6 months physical activity intervention on carotid IPH and other biomarkers of vulnerability for asymptomatic patients.

This study has been designed as a monocentric, longitudinal and interventional study. This study will involve one centre: Hopital Louis Pradel (HCL, Lyon). After inclusion tests, patients will be randomly included in the control group, or in the PA group. Patients of the PA group will have connected bracelets to measure daily count of steps. Twice a month, daily goals will be revaluated to increase or maintain the steps per day. The final goal is to reach 6 000 steps per day or increase by 30% the initial count of steps per day. Same tests will be done after 6 months of intervention for comparison.

Detailed Description

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Conditions

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Carotid Atherosclerosis

Keywords

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Intraplaque haemorrhage MRI home-based Physical activity carotic plaque vulnerability

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
Two experienced observers will blindly read the MRI scans.

Study Groups

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Individualized home-based physical activity

The subjects of this arm will have a daily goal in number of steps based on the initial 2 first week evaluation of daily number of steps. They will wear connected wrists, and will be contacted twice a month by phone call by the adapted physical activity trainer to revaluate these goals.

Group Type EXPERIMENTAL

individualized home-based physical activity

Intervention Type DEVICE

Subjects will have to reach a daily goal in number of steps, based on the initial evaluation, during 6 months . They will wear connected wrists, and will be contacted twice a month by phone call by an adapted physical activity to revaluate these goals.

MRI

Intervention Type OTHER

An MRI will be performed for each patient at the end of the study to identify IPH and other features of histological vulnerability (lipid core, fibrous cap integrity and calcifications).

blood sampling

Intervention Type BIOLOGICAL

Blood will be collected, to analyse monocyte phenotype by flow cytometry, blood rheology by ektacytometry, coagulation by rotational thromboelastometry (ROTEM). Plasma will be extracted from blood to assess inflammation, oxidative stress and antioxidant markers.

Questionnaires

Intervention Type OTHER

sedentary, physical activity, nutrition and quality of life questionnaire will be performed fo each patient.

6-minute walk test

Intervention Type OTHER

The 6-minute walk test is a simple, individualized test that measures how fast a patient walks on a flat, hard surface for 6 minutes.

Control group

The subjects of this arm will not have evaluation of daily steps and recommendations regarding physical activity and sedentary behaviour. They will be asked to live as usual.

Group Type ACTIVE_COMPARATOR

MRI

Intervention Type OTHER

An MRI will be performed for each patient at the end of the study to identify IPH and other features of histological vulnerability (lipid core, fibrous cap integrity and calcifications).

blood sampling

Intervention Type BIOLOGICAL

Blood will be collected, to analyse monocyte phenotype by flow cytometry, blood rheology by ektacytometry, coagulation by rotational thromboelastometry (ROTEM). Plasma will be extracted from blood to assess inflammation, oxidative stress and antioxidant markers.

Questionnaires

Intervention Type OTHER

sedentary, physical activity, nutrition and quality of life questionnaire will be performed fo each patient.

6-minute walk test

Intervention Type OTHER

The 6-minute walk test is a simple, individualized test that measures how fast a patient walks on a flat, hard surface for 6 minutes.

Interventions

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individualized home-based physical activity

Subjects will have to reach a daily goal in number of steps, based on the initial evaluation, during 6 months . They will wear connected wrists, and will be contacted twice a month by phone call by an adapted physical activity to revaluate these goals.

Intervention Type DEVICE

MRI

An MRI will be performed for each patient at the end of the study to identify IPH and other features of histological vulnerability (lipid core, fibrous cap integrity and calcifications).

Intervention Type OTHER

blood sampling

Blood will be collected, to analyse monocyte phenotype by flow cytometry, blood rheology by ektacytometry, coagulation by rotational thromboelastometry (ROTEM). Plasma will be extracted from blood to assess inflammation, oxidative stress and antioxidant markers.

Intervention Type BIOLOGICAL

Questionnaires

sedentary, physical activity, nutrition and quality of life questionnaire will be performed fo each patient.

Intervention Type OTHER

6-minute walk test

The 6-minute walk test is a simple, individualized test that measures how fast a patient walks on a flat, hard surface for 6 minutes.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient with an carotid atheromatous plaque with ≥ 50% North American Symptomatic Carotid Endarterectomy Trial (NASCET) stenosis
* Patient from vascular surgery department of the Louis Pradel Hospital of the Hospices Civils de Lyon, but not operated
* Males and females aged over 18 years old
* No contra-indication to physical activity with index performance (PS) \< 2
* Available and voluntary to invest in the study throughout its duration (6 months)
* Able to understand, read and write French;
* a social security system or similar;
* Having dated and signed informed consent.

Exclusion Criteria

* Transient ischemic attack (TIA) or ipsilateral cerebral infarction less than 6 months
* History of ipsilateral carotid surgery or cervical irradiation;
* Cancer, heart failure, seropositivity;
* Coronary risk;
* Renal failure (Cockcroft clearance of creatinine \< 30 milliliter/minute (mL/min);
* Contraindication and precautions for use related to Prohance: hypersensitivity to the active substance or to any of the constituents of Prohance, renal insufficiency with clearance \<30 ml / min / 1.73 m², probability of convulsions during the higher examination in patients with epilepsy or brain injury, pregnancy, breastfeeding;
* Contraindication to MRI: ferromagnetic material (including pacemaker, implantable defibrillators, cardiac valve prostheses, cochlear implants, neurostimulators, implanted automated injection equipment, intraocular metallic foreign bodies, neurosurgical and vascular clips);
* Carotid occlusion;
* ipsilateral intracranial stenosis;
* Risk of pregnancy or proven pregnancy on interrogation data. Breastfeeding;
* Patient under guardianship, under curatorship or safeguard of justice;
* inability to express consent;
* uncontrolled cardiological or neurological diseases;
* Impossibility of being followed for medical, social, geographical or psychological reasons throughout the duration of the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospices Civils de Lyon

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hôpital Louis Pradel

Bron, , France

Site Status

Countries

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France

References

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Mura M, Rivoire E, Dehina-Khenniche L, Weiss-Gayet M, Chazaud B, Faes C, Connes P, Long A, Rytz CL, Mury P, Delrieu L, Gouraud E, Bordet M, Della Schiava N, Lermusiaux P, Arsicot M, Millon A, Pialoux V. Effectiveness of an individualized home-based physical activity program in surgery-free non-endarterectomized asymptomatic stroke patients: a study protocol for the PACAPh interventional randomized trial. Trials. 2022 Feb 14;23(1):145. doi: 10.1186/s13063-022-06061-x.

Reference Type RESULT
PMID: 35164816 (View on PubMed)

Mura M, Rivoire E, Dehina-Khenniche L, Jazzar G, Schlatter S, Della-Schiava N, Arsicot M, Fayad ZA, Lermusiaux P, Long A, Douek P, Chirico EN, Thomas A, Pialoux V, Millon A. Influence of a six-month home-based individualized physical activity intervention on carotid plaque instability measured by magnetic resonance imaging: a randomized controlled clinical trial. EClinicalMedicine. 2025 Apr 22;83:103158. doi: 10.1016/j.eclinm.2025.103158. eCollection 2025 May.

Reference Type RESULT
PMID: 40548131 (View on PubMed)

Other Identifiers

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2019-A01543-54

Identifier Type: OTHER

Identifier Source: secondary_id

69HCL19_0345

Identifier Type: -

Identifier Source: org_study_id