1. Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction.
- Author
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Wang, Kang-Ling, Balmforth, Craig, Meah, Mohammed N., Daghem, Marwa, Moss, Alastair J., Tzolos, Evangelos, Kwiecinski, Jacek, Molek-Dziadosz, Patrycja, Craig, Neil, Bularga, Anda, Adamson, Philip D., Dawson, Dana K., Arumugam, Parthiban, Sabharwal, Nikant K., Greenwood, John P., Townend, Jonathan N., Calvert, Patrick A., Rudd, James H.F., Verjans, Johan W., and Berman, Daniel S.
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MYOCARDIAL infarction , *ATHEROSCLEROTIC plaque , *POSITRON emission tomography , *CORONARY artery disease , *CORONARY arteries - Abstract
Total coronary atherosclerotic plaque activity across the entire coronary arterial tree is associated with patient-level clinical outcomes. We aimed to investigate whether vessel-level coronary atherosclerotic plaque activity is associated with vessel-level myocardial infarction. 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. 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; P interaction = 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. 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. [Display omitted] [ABSTRACT FROM AUTHOR]
- Published
- 2024
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