Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction

Area of Science:

• Cardiovascular Imaging and Diagnostics
• Interventional Cardiology
• Nuclear Cardiology

Background:

• Total coronary atherosclerotic plaque activity correlates with patient outcomes.
• Assessing plaque activity at the vessel level is crucial for understanding localized risk.

Purpose of the Study:

• To determine if vessel-level coronary atherosclerotic plaque activity predicts vessel-level myocardial infarction.
• To investigate the prognostic value of plaque activity in patients with recent myocardial infarction and multivessel coronary artery disease.

Main Methods:

• Secondary analysis of an international multicenter study.
• Utilized coronary 18F-sodium fluoride positron emission tomography (PET) to assess plaque activity.
• Identified vessel-level myocardial infarction in patients with multivessel coronary artery disease.

Main Results:

• Increased 18F-sodium fluoride uptake (plaque activity) was observed in 679 of 2,094 coronary arteries.
• Vessels with increased plaque activity had a higher incidence of myocardial infarction (HR: 2.08).
• Plaque activity predicted myocardial infarction in untreated vessels (HR: 3.86) and heightened patient risk for cardiac events.

Conclusions:

• Coronary atherosclerotic plaque activity is a significant predictor of myocardial infarction at both the vessel and patient levels.
• This imaging biomarker aids in identifying high-risk coronary arteries and patients, guiding clinical management.