Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease.

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  • Additional Information
    • Affiliation:
      Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California; Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland
      Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California; British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
      British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
      Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
      British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
    • Abstract:
      Background: Reliable methods for predicting myocardial infarction in patients with established coronary artery disease are lacking. Coronary 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) provides an assessment of atherosclerosis activity.Objectives: This study assessed whether 18F-NaF PET predicts myocardial infarction and provides additional prognostic information to current methods of risk stratification.Methods: Patients with known coronary artery disease underwent 18F-NaF PET computed tomography and were followed up for fatal or nonfatal myocardial infarction over 42 months (interquartile range: 31 to 49 months). Total coronary 18F-NaF uptake was determined by the coronary microcalcification activity (CMA).Results: In a post hoc analysis of data collected for prospective observational studies, the authors studied 293 study participants (age: 65 ± 9 years; 84% men), of whom 203 (69%) showed increased coronary 18F-NaF activity (CMA >0). Fatal or nonfatal myocardial infarction occurred only in patients with increased coronary 18F-NaF activity (20 of 203 with a CMA >0 vs. 0 of 90 with a CMA of 0; p < 0.001). On receiver operator curve analysis, fatal or nonfatal myocardial infarction prediction was highest for 18F-NaF CMA, outperforming coronary calcium scoring, modified Duke coronary artery disease index and Reduction of Atherothrombosis for Continued Health (REACH) and Secondary Manifestations of Arterial Disease (SMART) risk scores (area under the curve: 0.76 vs. 0.54, 0.62, 0.52, and 0.54, respectively; p < 0.001 for all). Patients with CMA >1.56 had a >7-fold increase in fatal or nonfatal myocardial infarction (hazard ratio: 7.1; 95% confidence interval: 2.2 to 25.1; p = 0.003) independent of age, sex, risk factors, segment involvement and coronary calcium scores, presence of coronary stents, coronary stenosis, REACH and SMART scores, the Duke coronary artery disease index, and recent myocardial infarction.Conclusions: In patients with established coronary artery disease, 18F-NaF PET provides powerful independent prediction of fatal or nonfatal myocardial infarction.
    • Journal Subset:
      Biomedical; Peer Reviewed; USA
    • ISSN:
      0735-1097
    • MEDLINE Info:
      PMID: NLM32553260 NLM UID: 8301365
    • Grant Information:
      R01 HL135557/HL/NHLBI NIH HHS/United States
    • Publication Date:
      In Process
    • Publication Date:
      20200726
    • DOI:
      http://dx.doi.org/10.1016/j.jacc.2020.04.046
    • Accession Number:
      143840904
  • Citations
    • ABNT:
      KWIECINSKI, J. et al. Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease. Journal of the American College of Cardiology (JACC), [s. l.], v. 75, n. 24, p. 3061–3074, 2020. DOI 10.1016/j.jacc.2020.04.046. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143840904. Acesso em: 4 ago. 2020.
    • AMA:
      Kwiecinski J, Tzolos E, Adamson PD, et al. Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease. Journal of the American College of Cardiology (JACC). 2020;75(24):3061-3074. doi:10.1016/j.jacc.2020.04.046.
    • AMA11:
      Kwiecinski J, Tzolos E, Adamson PD, et al. Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease. Journal of the American College of Cardiology (JACC). 2020;75(24):3061-3074. doi:10.1016/j.jacc.2020.04.046
    • APA:
      Kwiecinski, J., Tzolos, E., Adamson, P. D., Cadet, S., Moss, A. J., Joshi, N., Williams, M. C., van Beek, E. J. R., Dey, D., Berman, D. S., Newby, D. E., Slomka, P. J., & Dweck, M. R. (2020). Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease. Journal of the American College of Cardiology (JACC), 75(24), 3061–3074. https://doi.org/10.1016/j.jacc.2020.04.046
    • Chicago/Turabian: Author-Date:
      Kwiecinski, Jacek, Evangelos Tzolos, Philip D Adamson, Sebastien Cadet, Alastair J Moss, Nikhil Joshi, Michelle C Williams, et al. 2020. “Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease.” Journal of the American College of Cardiology (JACC) 75 (24): 3061–74. doi:10.1016/j.jacc.2020.04.046.
    • Harvard:
      Kwiecinski, J. et al. (2020) ‘Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease’, Journal of the American College of Cardiology (JACC), 75(24), pp. 3061–3074. doi: 10.1016/j.jacc.2020.04.046.
    • Harvard: Australian:
      Kwiecinski, J, Tzolos, E, Adamson, PD, Cadet, S, Moss, AJ, Joshi, N, Williams, MC, van Beek, EJR, Dey, D, Berman, DS, Newby, DE, Slomka, PJ & Dweck, MR 2020, ‘Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease’, Journal of the American College of Cardiology (JACC), vol. 75, no. 24, pp. 3061–3074, viewed 4 August 2020, .
    • MLA:
      Kwiecinski, Jacek, et al. “Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease.” Journal of the American College of Cardiology (JACC), vol. 75, no. 24, June 2020, pp. 3061–3074. EBSCOhost, doi:10.1016/j.jacc.2020.04.046.
    • Chicago/Turabian: Humanities:
      Kwiecinski, Jacek, Evangelos Tzolos, Philip D Adamson, Sebastien Cadet, Alastair J Moss, Nikhil Joshi, Michelle C Williams, et al. “Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease.” Journal of the American College of Cardiology (JACC) 75, no. 24 (June 23, 2020): 3061–74. doi:10.1016/j.jacc.2020.04.046.
    • Vancouver/ICMJE:
      Kwiecinski J, Tzolos E, Adamson PD, Cadet S, Moss AJ, Joshi N, et al. Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease. Journal of the American College of Cardiology (JACC) [Internet]. 2020 Jun 23 [cited 2020 Aug 4];75(24):3061–74. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143840904