Ryota Iwatsuka1, Yuya Matsue2, Taishi Yonetsu3, Toshihiro O'uchi4, Akihiko Matsumura5, Yuji Hashimoto5, Kenzo Hirao6. 1. Department of Cardiology, Kameda Medical Center, Chiba, Japan; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: ryotaiwtk@gmail.com. 2. Department of Cardiology, Kameda Medical Center, Chiba, Japan; Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan. 3. Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan. 4. Department of Radiology, Kameda Medical Center, Chiba, Japan. 5. Department of Cardiology, Kameda Medical Center, Chiba, Japan. 6. Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Abstract
BACKGROUND AND AIMS: Although 18F-fluorodeoxyglucose (FDG) uptake has emerged as a sensitive and reliable marker of atherosclerotic inflammation, its additive predictive value for future coronary disease in older subjects is unknown. The aim of this study was to test the prognostic value of aortic inflammation detected via FDG-positron emission tomography (PET)-computed tomography (CT) in older subjects. METHODS: We retrospectively utilized the records of 309 subjects aged over 65 years, without a history of coronary artery disease, who underwent 18F-FDG-PET-CT mostly due to the clinical suspicion of cancer, but eventually turned out to be cancer-free. Target-to-background ratio (TBR) was calculated at the ascending aorta. The endpoint was occurrence of coronary heart disease (CHD) events. RESULTS: During a median follow-up of 3.9 years, 28 subjects experienced CHD events and 12 patients died due to non-CHD causes. The highest TBR tertile was associated with a high CHD event rate, accounting for death due to non-CHD causes as a competing risk (Gray test, p = 0.005). In a Fine and Gray competing risk proportional hazard regression model, TBR was associated with significantly high CHD events independently of FRS, with a hazard ratio (HR) of 1.19 per 0.1 TBR increase (p < 0.001). Likewise, a significant increase in the area under the curve (from 0.57 to 0.73, p = 0.028) and a significant improvement in net reclassification (0.42, p = 0.038) were observed when TBR was added to the model with FRS alone. CONCLUSIONS: In older subjects with no history of malignant disease or overt coronary artery disease, arterial inflammation evaluated by FDG uptake provides information on future occurrence of coronary artery events.
BACKGROUND AND AIMS: Although 18F-fluorodeoxyglucose (FDG) uptake has emerged as a sensitive and reliable marker of atherosclerotic inflammation, its additive predictive value for future coronary disease in older subjects is unknown. The aim of this study was to test the prognostic value of aortic inflammation detected via FDG-positron emission tomography (PET)-computed tomography (CT) in older subjects. METHODS: We retrospectively utilized the records of 309 subjects aged over 65 years, without a history of coronary artery disease, who underwent 18F-FDG-PET-CT mostly due to the clinical suspicion of cancer, but eventually turned out to be cancer-free. Target-to-background ratio (TBR) was calculated at the ascending aorta. The endpoint was occurrence of coronary heart disease (CHD) events. RESULTS: During a median follow-up of 3.9 years, 28 subjects experienced CHD events and 12 patients died due to non-CHD causes. The highest TBR tertile was associated with a high CHD event rate, accounting for death due to non-CHD causes as a competing risk (Gray test, p = 0.005). In a Fine and Gray competing risk proportional hazard regression model, TBR was associated with significantly high CHD events independently of FRS, with a hazard ratio (HR) of 1.19 per 0.1 TBR increase (p < 0.001). Likewise, a significant increase in the area under the curve (from 0.57 to 0.73, p = 0.028) and a significant improvement in net reclassification (0.42, p = 0.038) were observed when TBR was added to the model with FRS alone. CONCLUSIONS: In older subjects with no history of malignant disease or overt coronary artery disease, arterial inflammation evaluated by FDG uptake provides information on future occurrence of coronary artery events.
Authors: Karel-Jan D F Lensen; Alexandre E Voskuyl; Emile F I Comans; Conny J van der Laken; Ronald Boellaard; Yvo M Smulders Journal: Int J Cardiovasc Imaging Date: 2020-01-02 Impact factor: 2.357
Authors: Michael Mayer; Austin J Borja; Emily C Hancin; Thomas Auslander; Mona-Elisabeth Revheim; Mateen C Moghbel; Thomas J Werner; Abass Alavi; Chamith S Rajapakse Journal: Front Physiol Date: 2020-10-22 Impact factor: 4.566