Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction.
J Am Coll Cardiol
; 83(22): 2135-2144, 2024 Jun 04.
Article
em En
| MEDLINE
| ID: mdl-38811091
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Placa Aterosclerótica
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Infarto do Miocárdio
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2024
Tipo de documento:
Article