Temporal Changes in Coronary 18F-Fluoride Plaque Uptake in Patients with Coronary Atherosclerosis

Coronary F-18-sodium fluoride (F-18-fluoride) uptake is a marker of both atherosclerotic disease activity and disease progression. It is currently unknown whether there are rapid temporal changes in coronary F-18-fluoride uptake and whether these are more marked in those with clinically unstable coronary artery disease. This study aimed to deter-mine the natural history of coronary F-18-fluoride uptake over 12 mo in patients with either advanced chronic coronary artery disease or a recent myocardial infarction. Methods: Patients with established mul-tivessel coronary artery disease and either chronic disease or a recent acute myocardial infarction underwent coronary F-18-fluoride PET and CT angiography, which was repeated at 3, 6, or 12 mo. Coronary F-18-fluoride uptake was assessed in each vessel by measuring the coronary microcalcification activity (CMA). Coronary calcification was quantified by measuring calcium score, mass, and volume. Results: Fifty-nine patients had chronic coronary artery disease (median age, 68 y; 93% male), and 52 patients had a recent myocardial infarction (median age, 65 y; 83% male). Reflecting the greater burden of coro-nary artery disease, baseline CMA values were higher in those with chronic coronary artery disease. Coronary F-18-fluoride uptake (CMA . 0) was associated with higher baseline calcium scores (294 Agat-ston units [AU] [interquartile range, 116-483 AU] vs. 72 AU [interquar-tile range, 8-222 AU]; P < 0.001) and more rapid progression of coronary calcification scores (39 AU [interquartile range, 10-82 AU] vs. 12 AU [interquartile range, 1-36 AU]; P < 0.001) than was the absence of uptake (CMA 5 0). Coronary F-18-fluoride uptake did not markedly alter over the course of 3, 6, or 12 mo in patients with either chronic coronary artery disease or a recent myocardial infarction. Conclusion: Coronary F-18-fluoride uptake is associated with the severity and progression of coronary artery disease but does not undergo a rapid dynamic change in patients with chronic or unstable coronary artery disease. This finding suggests that coronary F-18-fluoride uptake is a temporally stable marker of established and progressive disease.

Automated summary

The study aimed to investigate the natural history of coronary F-18-fluoride uptake in patients with chronic coronary artery disease or recent myocardial infarction. The results showed that coronary F-18-fluoride uptake is associated with the severity and progression of coronary artery disease but does not undergo rapid dynamic changes in a short period of time.