Key result
Home-based physical activity reduces intraplaque hemorrhage scores by ~0.32 points in asymptomatic carotid stenosis.
Why the study?
Physical activity has been associated with lower carotid intraplaque haemorrhage prevalence, but the influence of a physical activity intervention on plaque instability in asymptomatic carotid stenosis was unknown.
Does a 6-month individualized home-based physical activity intervention reduce carotid intraplaque haemorrhage score measured by MRI in asymptomatic patients with carotid stenosis ≥50% NASCET?
RCT (n=56)
Single-blind
1:1
No
Does a 6-month individualized home-based physical activity intervention reduce carotid intraplaque haemorrhage score measured by MRI in asymptomatic patients with carotid stenosis ≥50% NASCET?
Effect estimate: Estimate difference -0.32 (95% CI -0.63 to -0.01)
Absolute Event Rate: -0.35% vs 0%
p-value: p=0.04
A 6-month moderate-intensity physical activity intervention significantly reduced carotid intraplaque hemorrhage severity on MRI in asymptomatic patients with carotid stenosis.
Supports home-based activity to reduce carotid plaque instability in asymptomatic stenosis; extends observational data with first RCT evidence.
Background: indicator of plaque instability and ischaemic risk. A cross-sectional study reported that physical activity was associated with lower prevalence of carotid intraplaque haemorrhage. The aim of this trial was to determine the influence of a physical activity intervention on plaque instability in asymptomatic patients with carotid stenosis. Methods: is a randomized clinical trial (ID-RCB:2019-A01543-54/SI:19.06.21.40640; registered on clinicaltrials.govNCT04053166). Patients were enrolled at University Hospital of Lyon, France, from December 2019 to March 2022. Fifty-six asymptomatic patients with carotid artery stenosis ≥50% NASCET were included and randomized 1:1 in an interventional physical activity arm or a control arm. The interventional arm underwent 6 months of an individualized home-based physical activity program, while the control arm followed usual care. The main outcome is the variation of the intraplaque haemorrhage score measured with high-resolution magnetic resonance imaging of the carotid plaque. All data were analysed with an intention to treat. Investigators were blinded from grouping. Findings: Out of 52 patients participating in the trial, 26 were allocated in each arm. The intraplaque haemorrhage score was significantly reduced over time in the physical activity arm (estimate difference: -0.32 ± 0.15, [95% CI -0.63 to -0.01], p = 0.04). The physical activity arm had increased daily step counts at the end of the 6-month intervention compared to the control arm (1843 ± 758, [CI95% 313-3373], p = 0.02). Interpretation: This trial demonstrates that an individualized home-based physical activity intervention could reduce the severity of intraplaque haemorrhage detected by magnetic resonance imaging and that it is feasible in asymptomatic patients with carotid atherosclerotic plaque. These results suggest that this type of moderate-intensity physical activity could be included in this population to the best medical treatment. Funding: .
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Mura et al. (2025) conducted an RCT in Asymptomatic carotid artery stenosis (n=56). Individualized home-based physical activity program vs. Usual care was evaluated on Variation of the intraplaque haemorrhage (IPH) score (Estimate difference -0.32, 95% CI -0.63 to -0.01, p=0.04). A six-month individualized home-based physical activity intervention significantly reduced the intraplaque haemorrhage score by an estimated difference of -0.32 compared to usual care in asymptomatic patients with carotid stenosis.
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