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Carotid FDG Uptake Improves Prediction of Future Cardiovascular Events in Asymptomatic Individuals.
Moon, Seung Hwan; Cho, Young Seok; Noh, Tae Soo; Choi, Joon Young; Kim, Byung-Tae; Lee, Kyung-Han.
Affiliation
  • Moon SH; Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Cho YS; Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Noh TS; Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Choi JY; Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Kim BT; Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Lee KH; Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: khnm.lee@samsung.com.
JACC Cardiovasc Imaging ; 8(8): 949-56, 2015 Aug.
Article in En | MEDLINE | ID: mdl-26189117
OBJECTIVES: This study sought to investigate the role of carotid fluoro-2-deoxyglucose (FDG) uptake as an independent prognostic indicator and to determine whether its addition improves risk prediction beyond the Framingham risk score (FRS) and carotid intima-media thickness (CIMT). BACKGROUND: The prognostic value of carotid FDG uptake independent of and incremental to traditional cardiovascular risk factors and CIMT in asymptomatic individuals has not been evaluated. METHODS: We measured carotid FDG uptake and CIMT in 1,089 asymptomatic adults (51.8 ± 6.3 years of age, 94.3% males) who underwent positron emission tomography/computed tomography imaging and examined the prognostic value of carotid FDG uptake compared with traditional risk factors and CIMT. RESULTS: Cardiocerebrovascular events occurred in 19 participants (1.74%) during an average follow-up of 4.2 years (range 1.0 to 5.5 years). Multivariable Cox proportional hazards analyses revealed that high carotid FDG uptake (hazard ratio: 2.98; 95% confidence interval: 1.17 to 7.62; p = 0.022) and high CIMT (hazard ratio: 2.82; 95% confidence interval: 1.13 to 7.03; p = 0.026) were independent predictors of events. Comparison of predictive power demonstrated that adding carotid FDG uptake, but not CIMT, to the FRS significantly increased the time-dependent area under the receiver-operating characteristic curve from 0.60 to 0.73 (p = 0.04). Furthermore, improvement approaching significance was achieved by adding carotid FDG uptake to the FRS plus CIMT, which increased the area under the receiver-operating characteristic curve from 0.65 to 0.75 (p = 0.07). Net reclassification for event prediction was similarly improved by addition of carotid FDG uptake to the FRS (net reclassification index, 40.1%; p = 0.06), as well as the FRS plus CIMT (net reclassification index, 32.9%; p = 0.07). CONCLUSIONS: High carotid FDG uptake predicts cardiovascular events independent of traditional risk factors and CIMT in asymptomatic adults and may add to risk stratification beyond the FRS and CIMT.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiovascular Diseases / Carotid Arteries / Glucose-6-Phosphate Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: JACC Cardiovasc Imaging Journal subject: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Year: 2015 Document type: Article Affiliation country: Korea (South) Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiovascular Diseases / Carotid Arteries / Glucose-6-Phosphate Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: JACC Cardiovasc Imaging Journal subject: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Year: 2015 Document type: Article Affiliation country: Korea (South) Country of publication: United States