Calcification Progression and Vascular Inflammation: A Substudy of the dal-PLAQUE Trial
Coronal CT, [18F]FDG-PET, and fused PET/CT images of the thorax and abdomen in a patient with established atherosclerosis are shown. White matter ([left panel CT] red arrows) is calcium within the atherosclerotic abdominal aorta. In the corresponding [18F]FDG-PET image (middle panel), there is little overlap of [18F]FDG signal in this region, confirmed on the fused image (right panel). In contrast, the ascending aorta ([middle and right panels] green arrows) is not calcified, but significant [18F]FDG uptake is seen. This snapshot illustrates that inflammation and calcification rarely overlap. The present paper extends these observations by highlighting the fact that different cardiovascular risk factors seem to drive vascular inflammation and calcification in the short term. We examined this in multiple vascular beds. Calcification progression over time is rare without calcium at baseline (“calcium begets calcium”), but the same does not apply to vascular inflammation. There was no effect on either pathological process of the HDL-raising therapy dalcetrapib. CT = computed tomography; [18F]FDG = 18F-labeled fluorodeoxyglucose; HDL = high-density lipoprotein; PET = positron emission tomography.