Author(s): PIALOUX, V., MURA, M., RIVOIRE, E., KHENNICHE, L., THOMAS, A., MILLON, A., Institution: UNIVERSITY CLAUDE BERNARD LYON 1, Country: FRANCE, Abstract-ID: 832

INTRODUCTION:
Atherosclerosis remains a major contributor to the global burden of deaths. Atherosclerotic plaques can be located in any large artery bifurcation, as the carotid or the lower limbs (i.e. Peripheral artery disease [PAD]). As the plaque becomes unstable, it can promote thromboembolism leading into a stroke or a limp, dependent of the plaque location. A large cohort study of 3 000 participants, demonstrated that subjects with higher physical activity rates had lower odds of PAD and carotid atherosclerosis. Inflammation and oxidative stress and two major pathophysiological mechanisms involved in the development and deterioration of carotid and lower limb atherosclerosis.
The Physical Activity and Carotid Atherosclerotic Plaque haemorrhage (PACAPh) study is a 6-month interventional study. This abstract focuses on the results of circulating inflammation and oxidative stress of the PACAPh study comparing PAD non-PAD patients of the cohort.
METHODS:
A total of 52 carotid atherosclerotic patients were included. At inclusion, sedentary (n=26) and non-sedentary (n=26; >8 and ≤8h/day sitting, Sedentary behaviour questionnaire); PAD (n=30) and non-PAD patients (n=22; ankle brachial index ≤ and > 0.90). Cytokines have been measured by multiplex and pro/antioxidant markers by colorimetric assay and enzymology. Wilcoxon rank-sum test was used to compare groups. Then the whole population was randomised 1:1 either in the physical activity or in the control group. In the physical activity group, the effect of the intervention on biological markers was tested in PAD and non-PAD patients. The interaction effect intervention*PAD was tested with a linear regression.
RESULTS:
At inclusion, the most sedentary patients had increased blood concentrations of the pro-inflammatory cytokines CCL27, CCL11, IL1b, and MIF (p<0.05) in comparison with less sedentary patients. At inclusion, PAD patients had increased rates of pro-oxidant enzyme MPO (p<0.05) compared with patients with only carotid atherosclerosis. Moreover, the physical activity intervention decreased the concentration of MPO in patients with PAD, while it stayed stable in patients with only carotid atherosclerosis (interaction p<0.05).
CONCLUSION:
These results suggest that the sedentary behaviour is associated with the level of circulating inflammatory markers in carotid atherosclerotic patients. It also appears that PAD increases the MPO pro-oxidant activity resulting mainly from circulating immune cells, in carotid atherosclerotic patients. More importantly, this MPO activity is reduced by our intervention specifically in PAD patients of our cohort. As our intervention is solely based on walking, it can be easily implemented in the everyday life of patients. In this context, reduce sedentary behaviour by practicing moderate intensity physical activity might be beneficial for these patients.