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. 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

^*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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