Coronary atherosclerotic plaque activity not associated with cardiac death, nonfatal MI or revascularization

New research revealed that in patients with recent myocardial infarction coronary atherosclerotic plaque activity was not associated with cardiac death, nonfatal myocardial infarction, or revascularization. The study results were published in JAMA Cardiology. 

Patients with recent myocardial infarction still experience recurrent coronary episodes, which can be a significant clinical issue. Individuals at risk can be identified using noninvasive indicators of coronary atherosclerotic disease activity. There is a high necessity to detect high-risk coronary artery plaques that drive downstream events and identify patients at risk of future coronary events. Many techniques have been developed that are invasive and impractical for widespread application. Hence researchers conducted a prospective, longitudinal, international multicenter cohort study to assess whether coronary atherosclerotic plaque activity as assessed by noninvasive imaging is associated with recurrent coronary events in patients with myocardial infarction. 

Participants aged 50 years or older with multivessel coronary artery disease and recent (within 21 days) myocardial infarction between September 2015 and February 2020 were identified and followed up for two years. Coronary 18F-sodium fluoride positron emission tomography and coronary computed tomography angiography were used. 18F-sodium fluoride uptake was used to assess the total coronary atherosclerotic plaque activity. Measuring cardiac death or any nonfatal myocardial infarctions, and any unscheduled coronary revascularization due to lower-than-anticipated primary event rates were the primary endpoints.