Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction

PRE18FFIR Study Investigators; Kang-Ling Wang; Craig Balmforth; Mohammed N. Meah; Marwa Daghem; Alastair J. Moss; Evangelos Tzolos; Jacek Kwiecinski; Patrycja Molek-Dziadosz; Neil Craig; Anda Bularga; Philip D. Adamson; Dana K. Dawson; Parthiban Arumugam; Nikant K. Sabharwal; John P. Greenwood; Jonathan N. Townend; Patrick A. Calvert; James H.F. Rudd; Johan W. Verjans; Daniel S. Berman; Piotr J. Slomka; Damini Dey; Nicholas L. Mills; Edwin J.R. van Beek; Michelle C. Williams; Marc R. Dweck; David E. Newby

doi:10.1016/j.jacc.2024.03.419

Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction

PRE18FFIR Study Investigators, Kang-Ling Wang^*, Craig Balmforth, Mohammed N. Meah, Marwa Daghem, Alastair J. Moss, Evangelos Tzolos, Jacek Kwiecinski, Patrycja Molek-Dziadosz, Neil Craig, Anda Bularga, Philip D. Adamson, Dana K. Dawson, Parthiban Arumugam, Nikant K. Sabharwal, John P. Greenwood, Jonathan N. Townend, Patrick A. Calvert, James H.F. Rudd, Johan W. VerjansDaniel S. Berman, Piotr J. Slomka, Damini Dey, Nicholas L. Mills, Edwin J.R. van Beek, Michelle C. Williams, Marc R. Dweck, David E. Newby

^*Corresponding author for this work

Cardiovascular Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

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; 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.

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.

Original language	English
Pages (from-to)	2135-2144
Number of pages	10
Journal	Journal of the American College of Cardiology
Volume	83
Issue number	22
Early online date	27 May 2024
DOIs	https://doi.org/10.1016/j.jacc.2024.03.419
Publication status	Published - 4 Jun 2024

Keywords

coronary atherosclerotic plaque activity
myocardial infarction
positron emission tomography

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10.1016/j.jacc.2024.03.419

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PRE18FFIR Study Investigators, Wang, K.-L., Balmforth, C., Meah, M. N., Daghem, M., Moss, A. J., Tzolos, E., Kwiecinski, J., Molek-Dziadosz, P., Craig, N., Bularga, A., Adamson, P. D., Dawson, D. K., Arumugam, P., Sabharwal, N. K., Greenwood, J. P., Townend, J. N., Calvert, P. A., Rudd, J. H. F., ... Newby, D. E. (2024). Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction. Journal of the American College of Cardiology, 83(22), 2135-2144. https://doi.org/10.1016/j.jacc.2024.03.419

@article{3a91e2383aa34bbc953a75c4ea0fbf5e,

title = "Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction",

abstract = "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.",

keywords = "coronary atherosclerotic plaque activity, myocardial infarction, positron emission tomography",

author = "{PRE18FFIR Study Investigators} and Kang-Ling Wang and Craig Balmforth and Meah, {Mohammed N.} and Marwa Daghem and Moss, {Alastair J.} and Evangelos Tzolos and Jacek Kwiecinski and Patrycja Molek-Dziadosz and Neil Craig and Anda Bularga and Adamson, {Philip D.} and Dawson, {Dana K.} and Parthiban Arumugam and Sabharwal, {Nikant K.} and Greenwood, {John P.} and Townend, {Jonathan N.} and Calvert, {Patrick A.} and Rudd, {James H.F.} and Verjans, {Johan W.} and Berman, {Daniel S.} and Slomka, {Piotr J.} and Damini Dey and Mills, {Nicholas L.} and {van Beek}, {Edwin J.R.} and Williams, {Michelle C.} and Dweck, {Marc R.} and Newby, {David E.}",

year = "2024",

month = jun,

day = "4",

doi = "10.1016/j.jacc.2024.03.419",

language = "English",

volume = "83",

pages = "2135--2144",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier",

number = "22",

}

PRE18FFIR Study Investigators, Wang, K-L, Balmforth, C, Meah, MN, Daghem, M, Moss, AJ, Tzolos, E, Kwiecinski, J, Molek-Dziadosz, P, Craig, N, Bularga, A, Adamson, PD, Dawson, DK, Arumugam, P, Sabharwal, NK, Greenwood, JP, Townend, JN, Calvert, PA, Rudd, JHF, Verjans, JW, Berman, DS, Slomka, PJ, Dey, D, Mills, NL, van Beek, EJR, Williams, MC, Dweck, MR & Newby, DE 2024, 'Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction', Journal of the American College of Cardiology, vol. 83, no. 22, pp. 2135-2144. https://doi.org/10.1016/j.jacc.2024.03.419

TY - JOUR

T1 - Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction

AU - PRE18FFIR Study Investigators

AU - Wang, Kang-Ling

AU - Balmforth, Craig

AU - Meah, Mohammed N.

AU - Daghem, Marwa

AU - Moss, Alastair J.

AU - Tzolos, Evangelos

AU - Kwiecinski, Jacek

AU - Molek-Dziadosz, Patrycja

AU - Craig, Neil

AU - Bularga, Anda

AU - Adamson, Philip D.

AU - Dawson, Dana K.

AU - Arumugam, Parthiban

AU - Sabharwal, Nikant K.

AU - Greenwood, John P.

AU - Townend, Jonathan N.

AU - Calvert, Patrick A.

AU - Rudd, James H.F.

AU - Verjans, Johan W.

AU - Berman, Daniel S.

AU - Slomka, Piotr J.

AU - Dey, Damini

AU - Mills, Nicholas L.

AU - van Beek, Edwin J.R.

AU - Williams, Michelle C.

AU - Dweck, Marc R.

AU - Newby, David E.

PY - 2024/6/4

Y1 - 2024/6/4

N2 - 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.

AB - 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.

KW - coronary atherosclerotic plaque activity

KW - myocardial infarction

KW - positron emission tomography

U2 - 10.1016/j.jacc.2024.03.419

DO - 10.1016/j.jacc.2024.03.419

M3 - Article

SN - 0735-1097

VL - 83

SP - 2135

EP - 2144

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 22

ER -

Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction

Abstract

Keywords

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