Coronary Arterial 18F-Sodium Fluoride Uptake: A Novel Marker of Plaque Biology

Study Questions:

Is coronary uptake of 18F-sodium fluoride (18F-NaF) increased in patients with atherosclerosis?

Methods:

One hundred and nineteen volunteers were recruited with and without aortic valve disease. Coronary calcium score along with 18F-NaF and 18F-fluorodeoxyglucose (18F-FDG) uptake were measured. Patients with a calcium score of 0 were used as control subjects and compared to those with calcific atherosclerosis.

Results:

Coronary 18F-NaF uptake was higher in patients with coronary atherosclerosis (n = 106) versus control subjects (1.64 ± 0.49 vs. 1.23 ± 0.24; p = 0.003) and correlated with the calcium score (r = 0.652, p > 0.001). Patients with increased coronary 18F-NaF activity (n = 40) had higher rates of prior cardiovascular events (p = 0.016) and angina (p = 0.023) and higher Framingham risk scores (p = 0.011). Quantification of coronary 18F-FDG uptake was hampered by myocardial activity and was not increased in patients with atherosclerosis versus control subjects (p = 0.498).

Conclusions:

The authors concluded that 18F-NaF is a promising new approach for the assessment of coronary artery plaque biology.

Perspective:

Noninvasive measures of atherosclerotic plaque metabolism using positron emission tomography may provide important insights into vulnerable plaques. In addition to confirming plaque response to treatments such as statins, this type of imaging could also guide additional systemic and/or local therapeutic interventions. Further research is needed to determine if increased coronary 18F-NaF uptake is predictive of plaque complications.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Dyslipidemia, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Atherosclerotic Disease (CAD/PAD), Congenital Heart Disease, CHD and Pediatrics and Imaging, CHD and Pediatrics and Interventions, CHD and Pediatrics and Prevention, Nonstatins, Novel Agents, Statins, Interventions and Coronary Artery Disease, Interventions and Imaging, Interventions and Structural Heart Disease, Angiography, Nuclear Imaging

Keywords: Coronary Artery Disease, Fluorodeoxyglucose F18, Atherosclerosis, Plaque, Atherosclerotic, Biological Markers, Heart Defects, Congenital, Coronary Angiography, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Sodium Fluoride


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