Thoracic aortic 18F-sodium fluoride PET predicts future ischemic stroke in CVD

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-03-17T09:00:44+05:30 | Updated On 17 March 2022 9:00 AM IST

UK: Thoracic aortic 18F-sodium fluoride activity in patients with established cardiovascular disease (CVD) is associated with the progression of atherosclerosis and future ischemic stroke, states a recent study in the journal JACC: Cardiovascular Imaging.

The study revealed that THE assessment of thoracic 18F-sodium fluoride positron emission tomography (PET) identifies localized areas of atherosclerotic disease activity that are directly associated with disease progression and downstream regional clinical atherothrombotic events.

Aortic atherosclerosis is known to be an important contributor to the risk of ischemic stroke. Identification of patients with high-risk aortic atheroma could boost preventative treatment strategies for future ischemic stroke. Considering this, Alexander J. Fletcher, University of Edinburgh, Edinburgh, United Kingdom, and colleagues aimed to investigate whether thoracic 18F-sodium fluoride positron emission tomography could improve the identification of patients at the highest risk of ischemic stroke in a post hoc observational cohort study.

For this purpose, the researchers quantified thoracic aortic and coronary 18F-sodium fluoride activity in 461 patients with stable cardiovascular disease undergoing PET combined with computed tomography (CT). Change in aortic and coronary CT calcium volume was used to assess the progression of atherosclerosis. The occurrence of ischemic stroke and myocardial infarction determined the clinical outcomes. The prognostic utility of 18F-sodium fluoride activity for predicting stroke was compared to clinical risk scores and CT calcium quantification using survival analysis and multivariable Cox regression.

Based on the study, the researchers found the following:

After 12.7 ± 2.7 months, progression of thoracic aortic calcium volume correlated with baseline thoracic aortic ¹⁸F-sodium fluoride activity (n = 140; r = 0.31).
In 461 patients, 23 (5%) patients experienced an ischemic stroke and 32 (7%) a myocardial infarction after 6.1 ± 2.3 years of follow-up.
High thoracic aortic ¹⁸F-sodium fluoride activity was strongly associated with ischemic stroke (HR: 10.3), but not myocardial infarction.
High coronary ¹⁸F-sodium fluoride activity was associated with myocardial infarction (HR: 4.8) but not ischemic stroke.
In a multivariable Cox regression model including imaging and clinical risk factors, thoracic aortic ¹⁸F-sodium fluoride activity was the only variable associated with ischemic stroke (HR: 8.19).

The researchers conclude, "thoracic aortic 18F-sodium fluoride activity is associated with the progression of atherosclerosis and future ischemic stroke in patients with CVD. However, the small number of stroke events means larger, adequately powered cohorts will be needed."

Reference

The study titled, "Thoracic Aortic 18F-Sodium Fluoride Activity and Ischemic Stroke in Patients With Established Cardiovascular Disease," was published in the journal JACC: Cardiovascular Imaging.

DOI: 10.1016/j.jcmg.2021.12.013

KEYWORDS: cardiovascular disease, PET, CT, ischemic stroke, Alexander J Fletcher, 18F-sodium fluoride activity, computed tomography, positron emission tomography, atherosclerotic disease, atherosclerosis

JACC: Cardiovascular Imagingcardiovascular diseasePETCTischemic stroke

Source : JACC: Cardiovascular Imaging

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751