Exercise and Low-Dose Rapamycin in Older Adults with CAD:Cardiac Rehabilitation And Rapamycin in Elderly (CARE) Trial

Overview

About this study

The investigators will do the study in two phases. The first phase will be a pilot study on up to 18 participants [patients 60 years or older with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) or patients who are eligible to undergo and participate in cardiac rehabilitation (CR)]; up to 6 participants each will be given oral daily rapamycin (0.5, 1, and 2mg) dose for the duration of CR. Baseline and follow-up data will be collected for age-associated impairment (AAI): frailty (primary endpoint) and quality of life (QOL),senescent-associated secretory phenotype (SASP)and abdominal/thigh subcutaneous adipose biopsy for measurement of adipocyte mitochondrial DNA copy number and to quantitate the number of senescent preadipocytes. Safety of rapamycin will be assessed by periodic clinical follow-up, blood draws, and serum rapamycin levels. Following completion of the pilot phase, the data will be analyzed. If favorable changes are noted in the SASP or AAI, the investigators will start a phase 2 randomized trial.

Second phase: In a prospective, randomized, clinical trial design, patients 60 years or older will be randomized at the time of CR to a standardized exercise protocol, or exercise protocol with the addition of low-dose rapamycin to test the hypothesis whether low-dose rapamycin (demonstrated in the pilot trial to improve SASP/AAI) will improve measures of AAI, SASP, or findings on the fat biopsy as compared to exercise alone. The null hypotheses are that there is no improvement with rapamycin in measures of AAI or SASP.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria

Age 60 years or older
Patients eligible to undergo cardiac rehabilitation.
Informed written consent.

Exclusion criteria

Class III or IV CHF.
Creatinine > 2.0 mg/dl.
HbA1c > 13%.
Any malignancy
Hematological disorder, including thrombocytopenia, leucopenia.
Noncardiac illness expected to limit survival.
Chronic liver disease.
Suspected or known pregnancy.
Geographically inaccessible or unable to return for follow-up.
Unable to understand or cooperate with protocol requirements.
Post organ transplant or with immune-compromised status
Prior stroke with disability, severe Parkinson disease
Dementia
Post-CABG <3 months or any evidence of active wounds or ulcers.
Anticipating elective surgery in the 3 months following enrollment.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location	Status
Rochester, Minn. Mayo Clinic principal investigator Mandeep Singh, M.D.	Closed for enrollment

Mayo Clinic Location

Status

Rochester, Minn.

Mayo Clinic principal investigator

Mandeep Singh, M.D.

Closed for enrollment

More information

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