Author + information
- Nikhil Vilas Joshi,
- Su Ern Yeoh,
- Michelle Williams,
- Miles Behan,
- Alison Fletcher,
- Nicholas Cruden,
- Nicholas Mills,
- Patrick A. Calvert,
- Edwin JR van Beek,
- Neal Uren,
- Daniel Berman,
- James Rudd,
- Marc Dweck and
- David Newby
Active calcification occurs within atherosclerotic plaque. Using positron emission (PET) and computed tomography (CT), we investigated coronary uptake of 18F–fluoride (18F–NaF) and 18F–fluorodeoxyglucose (18F–FDG) in patients with stable angina and acute coronary syndrome (ACS).
We prospectively recruited 53 patients with either stable angina (n=29) or ACS (n=24). All patients underwent gated 18F–NaF and 18F–FDG PET, and CT and invasive coronary angiography, with virtual histology intravascular ultrasound (VH–IVUS) in patients with stable angina (n=25).
In patients with stable angina, 11 (37%) had focal plaque 18F–NaF uptake (1.49 [1.25–1.99]) that, on VH–IVUS, had more necrotic core (25% vs 20%, p<0.05) and microcalcification (79% vs 22%, p<0.001) than plaques without 18F–NaF uptake. Intense 18F–NaF uptake occurred at the site of plaque rupture in patients with ACS (culprit lesion tissue–to–background ratio [TBR], 1.61 [1.50–1.75] vs maximum of all non–culprit plaques, 1.47 [1.25–1.50]; p<0.001; Fig 1). There were no differences in 18F–FDG uptake in culprit and non–culprit lesions (1.75 [1.36–2.22] vs 1.56 [1.32–1.56] p=0.13) or between patients with stable angina and ACS (1.54 [1.25–1.89] vs 1.56 [1.32–1.56]; p=0.41).
18F–NaF holds major promise as a novel biomarker of coronary plaque vulnerability or rupture that has applications for risk stratification, development of novel therapeutic interventions and monitoring of disease progression.
Special Session North, Room 120
Monday, March 11, 2013, 8:45 a.m.–9:00 a.m.
Session Title: Young Investigator Awards Competition: Clinical Investigations, Congenital Heart Disease, and Cardiovascular Surgery
Abstract Category: Clinical Investigations, Congenital Heart Disease, Cardiac Surgery
Presentation Number: 408–7
- 2013 American College of Cardiology Foundation