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NCT01212900

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

Completed Phase 4 Results posted Last updated 30 November 2018
What this trial tests

Phase 4 trial testing Statins, HMG CoA in Atherosclerosis in 230 participants. Completed in 22 February 2017.

Timeline
30 September 2010
Primary endpoint
30 November 2016
22 February 2017

Quick facts

Lead sponsorNational Heart, Lung, and Blood Institute (NHLBI)
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment230
Start date30 September 2010
Primary completion30 November 2016
Estimated completion22 February 2017
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

National Heart, Lung, and Blood Institute (NHLBI)

Who can join

Adults 50 to 99, any sex, with Atherosclerosis or Hypercholesterolemia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change in Mean of Wall Volume of Internal Carotid Arteries Primary · 24 months

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 S

GroupValue95% CI
Imaging-3.52-7.552305 – 0.506032
Standard-5.91-10.9683601 – -0.8536061

Adverse events — posted to ClinicalTrials.gov

Time frame: 24 months. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Imaging
Serious: 18/116 (16%)
Deaths: 0/116
Standard
Serious: 18/114 (16%)
Deaths: 1/114

Serious adverse events (33 terms)

ReactionSystemImagingStandard
Hepatic enzyme abnormalInvestigations
Arthroscopic surgerySurgical and medical procedures
Acute myocardial infarctionCardiac disorders
Coronary artery diseaseCardiac disorders
Gastrointestinal haemorrhageGastrointestinal disorders
PancreatitisGastrointestinal disorders
DeathGeneral disorders
CellulitisInfections and infestations
PneumoniaInfections and infestations
accidental overdoseInjury, poisoning and procedural complications
ConcussionInjury, poisoning and procedural complications
Blood creatine abnormalInvestigations
Haemoglobin abnormalInvestigations
HospitalisationInvestigations
adenocarcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Biopsy skinNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Gingival cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung neoplasm malignantNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Oral neoplasmNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Spinal cord herniationNervous system disorders
AmnesiaPsychiatric disorders
EpiglottitisRespiratory, thoracic and mediastinal disorders
Aortic surgerySurgical and medical procedures
Breast conserving surgerySurgical and medical procedures
Cardiac ablationSurgical and medical procedures
Other adverse events (105 terms — click to expand)

ReactionSystemImagingStandard
myalgiaMusculoskeletal and connective tissue disorders
ArthritisMusculoskeletal and connective tissue disorders
fatigueGeneral disorders
Blood pressure increasedInvestigations
Muscle contractions involuntaryMusculoskeletal and connective tissue disorders
ParaesthesiaNervous system disorders
PalpitationsCardiac disorders
Chest painGeneral disorders
NoduleGeneral disorders
OedemaGeneral disorders
Blood creatine abnormalInvestigations
Back painMusculoskeletal and connective tissue disorders
FractureMusculoskeletal and connective tissue disorders
PainMusculoskeletal and connective tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
Tendon painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
Neuropathy peripheralNervous system disorders
Upper respiratory tract infectionRespiratory, thoracic and mediastinal disorders
AlopeciaSkin and subcutaneous tissue disorders
AnaemiaBlood and lymphatic system disorders
HyperbilirubinaemiaBlood and lymphatic system disorders
LymphadenopathyBlood and lymphatic system disorders
Chest discomfortCardiac disorders
DyspnoeaCardiac disorders
PresyncopeCardiac disorders
External ear painEar and labyrinth disorders
HypoacusisEar and labyrinth disorders
Otitis externaEar and labyrinth disorders
TinnitusEar and labyrinth disorders
VertigoEar and labyrinth disorders
GoitreEndocrine disorders
HypothyroidismEndocrine disorders
Dry eyeEye disorders
Retinal haemorrhageEye disorders
Visual impairmentEye disorders
DiarrhoeaGastrointestinal disorders
Dry mouthGastrointestinal disorders
DysphagiaGastrointestinal disorders
GastritisGastrointestinal disorders

Most-reported serious reactions: Hepatic enzyme abnormal, Arthroscopic surgery, Acute myocardial infarction, Coronary artery disease, Gastrointestinal haemorrhage, Pancreatitis, Death, Cellulitis.

Data from ClinicalTrials.gov NCT01212900 adverse events section.

Sponsor's own description

Background: \- Atherosclerosis (thickening of the artery walls caused by cholesterol and other deposits) commonly occurs in the heart vessels and carotid (neck) arteries of adults. This is often present in individuals with high cholesterol levels in their blood. These patients are usually treated with cholesterol lowering medication ( statins ) along with modification of diet and exercise. Researchers are interested in investigating new approaches including magnetic resonance imaging (MRI) and computed tomography (CT) imaging studies to detect blood vessel blockages that would not otherwise be detected by cholesterol levels and risk factors for heart disease. Objectives: \- To measure atherosclerosis in the heart vessels and carotid arteries using imaging tests (computed tomography (CT) and magnetic resonance imaging (MRI)) before and after standard treatment with cholesterol lowering medication ( statins ) Eligibility: \- Healthy individuals at least 55 years of age who are candidates for therapy to lower their blood cholesterol levels. Design: * This study will involve one screening visit and seven study visits over a period of 2 years. * Participants will be screened with a physical examination and medical history, as well as blood samples and tests to ensure that it is safe for them to have CT and MRI scans. Participants will provide information on current medications, dietary habits, smoking status, alcohol and caffeine intake, and their level of physical activity. * Participants will be divided into two groups. One group will receive standard doses of medication to lower cholesterol according to current treatment guidelines, while the other group will have MRI scans of the carotid arteries and a CT scan of the heart to determine the best medication dose levels. * Visits 3 to 5 will be scheduled 3, 6, and 9 months after visit 2. During these visits, researchers will monitor for possible side effects and may change or adjust medications and doses. * At visit 6, participants will have an MRI scan of the carotid arteries, a physical examination, and blood tests. Medications may be changed or adjusted. * At visit 7, participants will have blood tests, and medications may be changed or adjusted. * At the final visit, participants will have MRI and CT scans of the carotid arteries and heart, respectively, as well as a final physical examination and blood tests.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

  1. <sup>18</sup> F-Fluorodeoxyglucose-Positron Emission Tomography As an Imaging Biomarker in a Prospective, Longitudinal Cohort of Patients With Large Vessel Vasculitis.
    Grayson PC, Alehashemi S, Bagheri AA, Civelek AC, et al · · 2018 · cited 235× · PMID 29145713 · DOI 10.1002/art.40379
  2. Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.
    Rodriguez K, Kwan AC, Lai S, Lima JA, et al · · 2015 · cited 45× · PMID 26035436 · DOI 10.1148/radiol.2015142551
  3. Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment.
    Sandfort V, Lai S, Ahlman MA, Mallek M, et al · · 2016 · cited 24× · PMID 27413040 · DOI 10.1161/jaha.116.003621
  4. Inflammation, coronary plaque progression, and statin use: A secondary analysis of the Risk Stratification with Image Guidance of HMG CoA Reductase Inhibitor Therapy (RIGHT) study.
    Scott C, Lateef SS, Hong CG, Dey AK, et al · · 2022 · cited 7× · PMID 35366378 · DOI 10.1002/clc.23808
  5. Internal tissue references for 18Fluorodeoxyglucose vascular inflammation imaging: Implications for cardiovascular risk stratification and clinical trials.
    Ahlman MA, Vigneault DM, Sandfort V, Maass-Moreno R, et al · · 2017 · cited 7× · PMID 29131857 · DOI 10.1371/journal.pone.0187995
  6. Coronary CT Angiography and Carotid MRI Improve Phenotyping of Disease Extent Compared with ACC/AHA Risk Score Alone.
    Chorath A, Choi Y, Turkbey EB, Ahlman MA, et al · · 2020 · cited 2× · PMID 32715300 · DOI 10.1148/ryct.2020190068

Verify or expand the search:

Other recruiting trials for Atherosclerosis

Currently open trials in the same condition.

Other National Heart, Lung, and Blood Institute (NHLBI) trials

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Data sources for this page

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing