18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial
18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial
复制标题
DOI：
10.1016/s0140-6736(13)61754-7
复制
发表时间：
2014-02-22
期刊：
影响因子：
168.9
通讯作者：
Newby, David E.
中科院分区：
文献类型：
--
作者：
Joshi, Nikhil V.;Vesey, Alex T.;Newby, David E.
使用无创成像技术识别破裂或高危冠状动脉粥样硬化斑块将是冠状动脉疾病预防和治疗的重大临床进展。我们使用放射性示踪剂f -18氟化钠（F-18-NaF）和f -18氟脱氧葡萄糖（F-18-FDG）联合PET和CT来识别破裂和高风险的动脉粥样硬化斑块。方法在前瞻性临床试验中，40例心肌梗死患者（n=40）和稳定性心绞痛患者（n=40）分别行F-18-NaF和F-18-FDG PET-CT和有创冠状动脉造影。将F-18-NaF摄取与症状性颈动脉疾病患者颈动脉内膜切除术标本的组织学和稳定型心绞痛患者的血管内超声进行比较。主要终点是比较急性心肌梗死患者的罪魁祸首和非罪魁祸首冠状动脉斑块的f -18氟化物组织与背景比率。在37例（93%）心肌梗死患者中，罪魁祸首斑块的冠状动脉F-18-NaF摄取最高(组织与背景比中值最大值：罪魁祸首1.66 [IQR 1.40-2.25] vs非罪魁祸首最高1.24 [1.06-1.38],p
Background The use of non-invasive imaging to identify ruptured or high-risk coronary atherosclerotic plaques would represent a major clinical advance for prevention and treatment of coronary artery disease. We used combined PET and CT to identify ruptured and high-risk atherosclerotic plaques using the radioactive tracers F-18-sodium fluoride (F-18-NaF) and F-18-fluorodeoxyglucose (F-18-FDG).Methods In this prospective clinical trial, patients with myocardial infarction (n=40) and stable angina (n=40) underwent F-18-NaF and F-18-FDG PET-CT, and invasive coronary angiography. F-18-NaF uptake was compared with histology in carotid endarterectomy specimens from patients with symptomatic carotid disease, and with intravascular ultrasound in patients with stable angina. The primary endpoint was the comparison of F-18-fluoride tissue-to-background ratios of culprit and non-culprit coronary plaques of patients with acute myocardial infarction.Findings In 37 (93%) patients with myocardial infarction, the highest coronary F-18-NaF uptake was seen in the culprit plaque (median maximum tissue-to-background ratio: culprit 1.66 [IQR 1.40-2.25] vs highest non-culprit 1.24 [1.06-1.38], p