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18F-NaF PET uptake characteristics of coronary artery culprit lesions in a cohort of patients of acute coronary syndrome with ST-elevation myocardial infarction and chronic stable angina: A hybrid fluoride PET/CTCA study

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

18F-NaF PET/CT identifies high-risk plaques due to active calcification in coronary arteries with potential to characterize plaques in ST-elevation myocardial infarction (MI) and chronic stable angina (CSA) patients.

Methods

Twenty-four MI and 17 CSA patients were evaluated with 18F-NaF PET/CTCA for SUVmax and TBR values of culprit and non-culprit plaques in both groups (inter-group and intra-group comparison), and pre- and post-interventional MI plaques sub-analysis.

Results

Culprit plaques in MI patients had significantly higher SUVmax (1.6; IQR 0.6 vs 1.3; IQR 0.3, P = 0.03) and TBR (1.4; IQR 0.6 vs 1.1; IQR 0.4, P = 0.006) than culprit plaques of CSA. Pre-interventional culprit plaques of MI group (n = 11) revealed higher SUVmax (P = 0.007) and TBR (P = 0.008) values than culprit CSA plaques. Culprit plaques showed significantly higher SUVmax (P = 0.006) and TBR (P = 0.0003) than non-culprit plaques in MI group, but without significant difference between culprit and non-culprit plaques in CSA group. With median TBR cutoff value of 1.4 in MI culprit plaques, 6/7 plaques (85.7%) among the event prone non-culprit lesions had TBR values > 1.4 in CSA group.

Conclusion

The study shows higher SUVmax and TBR values in MI culprit plaques and comparable TBR values for event prone plaques of CSA group in identifying high-risk plaques.

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Abbreviations

MI:

Myocardial infarction

CSA:

Chronic stable angina

PET:

Positron emission tomography

CTCA:

Computed tomography coronary angiography

ACS:

Acute coronary syndrome

CTAC:

CT attenuation correction

ROI:

Region of interest

SUV:

Standardized uptake value

FDG:

Fluorodeoxyglucose

LAD:

Left anterior descending

RCA:

Right coronary artery

LCX:

Left circumflex artery

IVUS:

Intravascular ultrasound

OCT:

Optical coherence tomography

ECHO:

Echocardiography

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Disclosure

Drs Abhiram G. Ashwathanarayana, SwayamjeetSatapathy, Ashwani Sood, Manphool Singhal, Bhagwant Rai Mittal, Rohit Manoj Kumar, Darshan Krishnappa, Nivedita Rana and Mr. Madan Parmar have nothing to disclose. No financial support was received for the publication of this manuscript.

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Author notes

  1. Abhiram G. Ashwathanarayana and Manphool Singhal may be credited as first co-authors.

Authors and Affiliations

  1. Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Abhiram G. Ashwathanarayana MD, Swayamjeet Satapathy MBBS, Ashwani Sood DNB, Bhagwant Rai Mittal MD, DNB, Madan Parmar MSc & Nivedita Rana PhD

  2. Department of Radio-Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Manphool Singhal MD, DNB

  3. Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Rohit Manoj Kumar MD, DM & Darshan Krishnappa MD, DM

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  1. Abhiram G. Ashwathanarayana MD
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Ashwathanarayana, A.G., Singhal, M., Satapathy, S. et al. 18F-NaF PET uptake characteristics of coronary artery culprit lesions in a cohort of patients of acute coronary syndrome with ST-elevation myocardial infarction and chronic stable angina: A hybrid fluoride PET/CTCA study. J. Nucl. Cardiol. 29, 558–568 (2022). https://doi.org/10.1007/s12350-020-02284-0

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