![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)
Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction
Kang-Ling Wang1, Craig Balmforth2, Mohammed N Meah2
1Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Insights
Coronary atherosclerotic plaque activity predicts myocardial infarction risk in individual arteries and patients. This finding highlights plaque activity as a key factor in assessing cardiovascular risk.
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.
Background:
Total coronary atherosclerotic plaque activity across the entire coronary arterial tree is associated with patient-level clinical outcomes.
Objectives:
We aimed to investigate whether vessel-level coronary atherosclerotic plaque activity is associated with vessel-level myocardial infarction.
Methods:
In this secondary analysis of an international multicenter study of patients with recent myocardial infarction and multivessel coronary artery disease, we assessed vessel-level coronary atherosclerotic plaque activity using coronary 18F-sodium fluoride positron emission tomography to identify vessel-level myocardial infarction.
Results:
Increased 18F-sodium fluoride uptake was found in 679 of 2,094 coronary arteries and 414 of 691 patients. Myocardial infarction occurred in 24 (4%) vessels with increased coronary atherosclerotic plaque activity and in 25 (2%) vessels without increased coronary atherosclerotic plaque activity (HR: 2.08; 95% CI: 1.16-3.72; P = 0.013). This association was not demonstrable in those treated with coronary revascularization (HR: 1.02; 95% CI: 0.47-2.25) but was notable in untreated vessels (HR: 3.86; 95% CI: 1.63-9.10; Pinteraction = 0.024). Increased coronary atherosclerotic plaque activity in multiple coronary arteries was associated with heightened patient-level risk of cardiac death or myocardial infarction (HR: 2.43; 95% CI: 1.37-4.30; P = 0.002) as well as first (HR: 2.19; 95% CI: 1.18-4.06; P = 0.013) and total (HR: 2.50; 95% CI: 1.42-4.39; P = 0.002) myocardial infarctions.
Conclusions:
In patients with recent myocardial infarction and multivessel coronary artery disease, coronary atherosclerotic plaque activity prognosticates individual coronary arteries and patients at risk for myocardial infarction.
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