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157 18F-sodium fluoride positron emission tomography, aortic disease activity and ischaemic stroke risk

Year: 2021
Type: conference-paper
Abstract: Background Arterial 18F-sodium fluoride (18F-NaF) activity on positron emission tomography (PET) is a marker of active microcalcification and atherosclerosis. Coronary 18F-NaF activity (CMA) predicts coronary artery disease progression and subsequent myocardial infarction. We aimed to investigate whether aortic 18F-NaF activity (AMA) predicts thoracic aortic atherosclerotic disease progression and subsequent ischaemic stroke in patients with established cardiovascular disease. Methods In a post-hoc observational cohort study, we evaluated AMA in patients with stable coronary artery disease (n=239) or aortic stenosis (n=158) who had underwent thoracic 18F-NaF PET and computed tomography (CT). We assessed the associations between AMA and progression of thoracic aortic calcification on follow up CT and subsequent ischaemic stroke or myocardial infarction. Results In 141 patients with repeat CT imaging at 12.7±2.7 months, AMA correlated with progression of thoracic aortic calcium scores (r=0.21, p=0.011). In 397 patients, 16 had an ischaemic stroke and 25 had a myocardial infarction after 4.7±1.6 years. After adjusting for clinical risk factors, CMA and calcium scoring, AMA was associated with stroke (hazard ratio, 1.71 [95% confidence interval 1.00-2.90], p=0.048]). AMA was superior to clinical risk and calcium scores in identifying patients with stroke (c-statistic 0.76 versus 0.58 versus 0.63 respectively, p<0.05). Survival analysis demonstrated that AMA was associated with ischaemic stroke (p<0.001) but not myocardial infarction (p=0.45), whereas CMA was associated with myocardial infarction (p<0.001) but not stroke (p=0.39). Conclusions In patients with established cardiovascular disease, AMA is associated with progression of aortic atherosclerosis and future ischaemic stroke. Arterial 18F-NaF identifies localised areas of atherosclerotic disease activity that relate to regional atherothrombotic events. Conflict of Interest none to delcare
DOI: 10.1136/heartjnl-2021-bcs.154
Authors: Alexander Fletcher, Evangelos Tzolos, Shruti Joshi, Jacek Kwiecinski, Rong Bing, Maaz Syed, Mhairi Doris, Edwin van Beek, Alistiar Moss, Niki Walker, Nikhil Joshi, Tania Pawade, Philip Adamson, William Whiteley, Joanna Wardlaw, Piotr Slomka, Michelle Williams, David Newby, Marc Dweck
Institutions: University of Edinburgh, Institute of Cardiology, Golden Jubilee National Hospital, Bristol Royal Infirmary, University of Bristol, University of Otago, Cedars-Sinai Medical Center
Language: English
Field: Medicine
Open Access status: gold
OpenAlex ID: W3166235064
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