Author(s): RIVOIRE, E., MURA, M., JOSSET, L., DEHINA-KHENNICHE, A., MILLON, A., LONG, A., PIALOUX, V., Institution: HÔPITAL CARDIOLOGIQUE LOUIS PRADEL, Country: FRANCE, Abstract-ID: 839

INTRODUCTION:
Lower extremities peripheral arterial disease (LE-PAD) associated with carotid atherosclerotic plaques increases the risk of ischemic events. Atherosclerotic patients with both LE-PAD and carotid plaque are at higher risk of unstable plaques1, which may be due, in part, to an increased level of chronic systemic low-grade inflammation. This may thereby place these individuals at a greater risk of stroke1, with more severe atherosclerotic damage2 and limitations to walking3 as compared to patients with only carotid plaque. Benefits of regular physical activity (PA) on morbidity, mortality and long-term quality of life were previously demonstrated in LE-PAD patients. Objective: Evaluate the effect of LE-PAD and PA on the risk of carotid plaque instability.
METHODS:
In this study, patients with carotid plaque with a stenosis >50% were divided in two groups: LE-PAD (+) and LE-PAD (-), according to ankle brachial index (ABI) or history of revascularization. Characterization of carotid plaque instability was evaluated by magnetic resonance imaging (MRI). PA and sedentary behavior were assessed by questionnaires and physical fitness by quadriceps strength and 6-minutes Walking Test (6-MWT).
RESULTS:
Fifty-two patients were included in this study (30 and 22 in LE-PAD (+) and (-) groups respectively). In LE-PAD (+) group the non-physically active patients (<1600 MET.min/weeks) and sedentary patients (>8h/day) had higher intraplaque haemorrhage (IPH) compared to physically active (p=.017) and non-sedentary patients (p=.06) respectively. Whereas these differences were not observed in LE-PAD (-) group. In the LE-PAD (-) group, 6-MWT distance was higher in the physically active patients compared to the non-physically active one (p<.00.1). On the contrary, there was no difference in 6-MWT distance between active and non-physically active subjects in the LE-PAD (+) group, suggesting that LE-PAD likely inhibits the impact of PA on the walking distance capacity.
CONCLUSION:
Patients with carotid plaques and LE-PAD may represent a subgroup at higher risk of cardiovascular-related complications, with greater plaque instability. However, increased PA and reduced sedentary behavior may limit these risks.
Conclusion: In the long term, systematic evaluation of lower limb vasculature by ABI measurement and completion of personalized PA may be beneficial for LE-PAD patients with carotid plaques.